
Qass. 
Book. 



COPYRIGHT DEPOSIT 



THE 



PRACTICE OF MEDICINE 



TEXT BOOK 



Homoeopathic Medicine, 

r 

ADAM GIVEN, M. D., 



Professor of Theory and Practice ok Medicine in South- 
western Homoeopathic College; Member of the 
American Institute of Homoeopathy, and of 
the Kentucky Homoeopathic Medical 
Society; Senior Neurologist to 
City Hospital of 
Louisville. 



LOUISVILLE, KY. 



BREWERS PRINTING HOUSE, 

INCORPORATED. 
1896. 






>f 






COPYRIGHTBD, 1896, 

By ADAM GIVEN, M. D. 



Electrotyped 
BY ROBERT ROWELL, 

LOUISVILLE, KY. 



PREFACE. 



When I began the study of Homoeopathy, I felt the need 
of a plain, practical text-book on Homoeopathic Medicine, one 
that could give me in as few words as possible the names of 
diseases, their etiology, symptomatology, pathology, diagnosis, 
prognosis, and treatment. In looking over the works then 
published I found many that were valuable productions, but 
too voluminous as text books for students and busy practi- 
tioners, while others left out much that students ought to 
know. 

While I am strictly a symptomatical prescriber, yet I think 
that homoeopathic students should be drilled in pathology, 
diagnosis, and everything that is valuable and knowable in 
medicine. 

Thirty-eight years of clinical experience in both schools, 
enabled me to prepare my lectures for our class, and to arrange 
this work upon a thoroughly practical basis, and avoid much 
that is theoretical and perplexing to beginners in medicine.. 

To avoid the repetition of names in the body of the work 
and the use of quotation marks, I here acknowledge that E 
have culled and quoted from the most practical authors within 
my reach, among whom I mention Hering, Cowperthwaite, 
Burt, Arnt, Neidhard, Johnson's Key, Raue, Allan, Franklin, 
Goodno, Ruddock, Bell, Davis, Andrews, King, Burnett, 
Hooper, Dewey, Alden, Druit, Charles K. Fisher, &c. 



4 PREFACE. 

I have made no effort to imitate, but when I found that 
any of the above authors expressed themselves in a plain prac- 
tical manner, which coincided with my own experience, I have 
quoted them verbatim, especially is this the case with those 
materia medicists who profess to give the provings of drugs 
by Hahnemann and other provers. 

Under the treatment of each disease I have left out many 
minor symptoms of drugs, and given only the most prominent 
or grand characteristic indications without encumbering the 
mind with too much, for I have learned from experience that 
when the grand characteristic of any drug is pointed out by 
the symptoms of the disease, then that drug always gave re- 
lief whether it saved the patient or not. 

In my method of teaching I have aimed to keep the atten- 
tion of students fixed upon the law of similia as their guiding 
star and their surest road to medical success. 

Adam Given, M. D., 

1403 West Jefferson Street, 

Louisvn,i,E, Ky. 
April, 1S96. 



HISTORY OF MEDICINE 



i 

Before taking up the study of medicine proper it will be 
well for us to spend a little while in the> examination of its 
history, «o as to enable us to appreciate its progress through 
the past ages. Medicine is both an art and a science when 
properly understood. While it was a very crude art as prac- 
ticed by the ancients, yet it improved little by little, until it 
has become a fine and useful art, when practiced in accord- 
ance with Nature's law of cure. It has ever been the aim of 
the medical profession, in all ages, to place medicine upon a 
firm, scientific basis, but owing to the antagonistic views of 
many in the profession and ignorance and superstition among 
many of the laity in different ages, medicine had a hard 
struggle to reach the high elevation it occupies to-day. 

By noting the various changes in the treatment of diseas- 
es and the conflicting views of practitioners in different ages, 
then we will be better prepared to appreciate the- necessity 
for the advent of Homoeopathy upon the medical stage, and 
thus be able to demonstrate its superiority as a scientific 
school of medicine. 

There can be no doubt that the healing art, though crude, 
began soon after the expulsion of Adam and Eve from the 
Garden of Eden. 

The Old Testament frequently alludes to the practice of 
medicine among the Jews. We have many names mentioned 
as prominent healers of their day, but some were legendary. 
We have nothing authentic until Hippocrates came upon the 
stage of action. He was born on the Island of Cos, B. C. 460. 
He was probably the first who began to lay the foundation of 



6 THEORY AND PRACTICE OF MEDICINE. 

the Science and Art of Medicine. It is said that the Hippo- 
cratic collection of works were more than sixty in number. 
His advance was so great that no attempts were made for 
some centuries to improve on his views and precepts, His 
sons, Thessalus and Draco, and his son-in-law, Polybius, are 
regarded as the founders of the medical sect called the Hip- 
pocratean or Dogmatic School, because it professed to set out 
with certain theoretical principles which were derived from 
the generalization of facts and observations, and to make 
these principles the basis of practice. Hippocrates was the 
first to discard superstition and to use inductive philosophy 
as the basis of medical practice. 

In general Hippocrates divided the causes of disease into 
two principal classes ; the first the influence of seasons, climate, 
water, situation, etc.; the second, more personal causes, e g., 
the food and exercise of the individual patient. His belief in 
the influence which different climates exert on the human 
constitution is very strongly expressed. He ascribes to this 
influence both the conformation of the body, and the disposition 
of the mind, and hence accounts for the difference between the 
hardy Greek and the Asiatic. The four fluids or humors of 
the body (blood, phlegm, yellow bile and black bile) were 
regarded by him as the primary seats of disease ; health was the 
result of the due combination (or crisis) of these, and illness 
was the consequence of a disturbance of this crisis. When a 
disease was proceeding favorably, these humors underwent a 
certain change, which was the sign of returning health, as 
preparing the way for the expulsion of morbid matter, or crisis, 
these crises having a tendency to occur at definite periods, 
which were hence called " critical " days. His treatment of 
diseases was cautious, now termed expectant ; it consisted 
chiefly, often solely, in attention to diet and regimen ; and he 
was sometimes reproached with letting his patients die by do- 
ing nothing to keep them alive ? 

The Hippocratic oath is a formula sometimes attributed 
to Hippocrates, for the subscription of those about to become 



THEORY AND PRACTICE OF MEDICINE. 7 

physicians, promising good faith to the profession and good 
conduct. 

From the days of Hippocrates to those of Galen, the 
medical profession was divided into several sects, always 
disputing with one another. They were known as Dogmatici, 
Bpirici, Eclectici, Pneumatici and Episynthetici. After Galen 
all these sects seem to have merged in his followers. 

Galen was born about 201 A. D. at Pergamus in Mysia. 
He did much to elevate medicine as a science and a useful art. 
He wrote works on anatomy, physiology, dietetics and hygi- 
ene, pathology, diagnosis and semiology, pharmacy and mate- 
ria medica, therapeutics and surgery. Galen was probably the 
first physician who enlarged the boundaries of medical science 
and gave us a more extended view of its utility. Yet in his 
day the facilities were so limited that he could only call up 
some of the useful branches that led his followers to gain a 
glimpse of the beautiful fields that he had partially explored, 
and those which came up before his vision he could only mark 
as unexplored. Since Galen's day medicine has made rapid 
marches until now it is numbered among the most attractive 
and useful branches of science. 

As an art, medicine has had its ups and downs. Its advo- 
cates have been divided into many sects, each claiming their 
theory the best. After the sect called chemical physicians 
had their day, then arose the sect called mathematical physi- 
cians, and superseded the chemists, and as they advanced the 
old Galenists fast disappeared. A rival sect arose called the 
Vitalists, that is those who believe that no vital phenome- 
non, such as digestion, can be explained on purely physical 
and chemical principles, but every such action is conditioned 
by an unknown force, higher in its nature and distinct in 
kind as compared with all other forces. 

At the present time the medical profession is divided into 
four principal sects or schools, viz: Eclectics, Hydropathists, 
Allopathists, and Homoeopathists. 

1. Eclectics. A sect of physicians who professed to 



8 THEORY AND PRACTICE OF MEDICINE. 

choose, from other sects, all the opinions which appeared to 
them best founded. Agathinus of Sparta was its reputed 
founder, who probably nourished about the first century of 
the Christian era. The eclectic school of medicine is. quite 
prosperous in certain localities. They have always opposed 
heroic treatment, such as blood-letting, the use of antimony 
and mercury. 

2. Hydropathy or Hygienic Medicine, is popularly 
termed the water-cure. The efficacy of water, in the cure of 
numerous forms of disease, has long been recognized. Water 
was largely employed by Hippocrates, the "father of medi- 
cine," more than 2,300 years ago, in the treatment of many 
kinds of disease, and with a regulated diet, and an implicit 
belief in the vis medicatrix natura ( Nature's healing force ), 
it appears to have formed the chief among his medical 
appliances. The water-cure has become very popular all over 
the world. In fact hydropathy has become an adjunct to 
all other schools of medicine. 

3. Allopathy, is that mode of medical practice which 
consists in the use of drugs to produce in the body a condi- 
tion opposite to the disease to be cured, the ordinary method 
of practice. It is opposed to homoeopathy, which attempts 
to cure disease by medicine which, in a state of health, would 
have produced a similar disease. 

The term allopathy is now applied to those who call 
themselves "regulars or old school." They profess to ignore 
the terms antipathic and allopathic, and yet they practice 
both systems. We can only tell a man's religion and politics 
by the doctrines he teaches. Hence if men practice allo- 
pathy they of necessity must be called allopaths. They have 
no more claim to be called old school than have eclectics, 
hydropaths and homoeopaths, for Hippocrates the " father of 
medicine," practiced eclecticism and hydropathy in connec- 
tion with antipathy and allopathy ; and he unwittingly prac- 
ticed homoeopathy 2,220 years before Hahnemann formulated 
the system. 



THEORY AND PRACTICE OF MEDICINE. 9 

There seems to be a demand in certain localities, both 
among allopaths and homoeopaths, to drop the term pathy 
in medicine. That will be well enough when all schools 
agree to unite, and practice the same method, or allow all 
practitioners to prescribe whatever, in their judgment, is 
best suited to each individual case. Then and not until then 
can the term " pathy " be dropped, with propriety, from the 
different systems of medicine. There can be no doubt that 
it would be to the best interest of the profession in general, 
and the laity in particular, if all schools of medicine would 
agree upon one system and practice in accordance with the 
law established by nature. 

To further illustrate the allopathic method of treatment I 
quote from one or their standard authors, who says : "Accord- 
ing to the homceopathists there are only three possible rela- 
tions between the symptoms of disease and the specific effects 
of medicine, namely opposition, resemblance and heteroge- 
nity. It follows, therefore, that there are only three imag- 
inable methods of employing medicines against disease ; and 
these are denominated, antipathic, homoeopathic, and allo- 
pathic. The antipathic or palliative method, consists in 
employing medicines which produce effects of an opposite 
nature to the symptoms of the disease, and the axiom adopted 
is ' contrary contraries opponendo? Though this principle 
was admitted in several ancient schools, yet it was explained 
and carried out at different periods in very different ways. 
Thus Hippocrates, who may be regarded as the founder of 
this doctrine, observes that all diseases which proceed from 
evacuation are cured by repletion. And so on in the rest ; 
contraries are the remedies of contraries. The methodists 
also adopted it, though in a different sense, when they treated 
the strictum by relaxing agents, and the laxum by astrin- 
gents. The Galenists, likewise, were antipaths, since they 
employed hot remedies to combat cold diseases, and treated 
moist maladies by dry remedies. " 

" We adopt this practice, " says the same author, u when we 



IO THEORY AND PRACTICE OF MEDICINE. 

employ purgatives to relieve constipation, depletion to coun- 
teract plethora ; cold to alleviate the effects of scalds ; narcot- 
ics to diminish preternatural sensibility or pain ; opium to 
check diarrhea ; and astringents to combat relaxation. 

The homceopathists object to antipathic remedies on the 
ground, that though the primary effects of these agents may 
be opposite to the phenomena of disease, the secondary effects 
are similar to them. Constipation excited by opium (primi- 
tive effect) is followed by diarrhea (secondary effect), and 
evacuations produced by purgatives (primitive effect) are 
succeeded by costiveness which lasts several days (secondary 
effect). 

Having glanced briefly at the systems of medicine as 
practiced by the profession in different ages from Hippocrates 
to A. D. 1790, when Samuel Hahnemann began to formulate 
homoeopathy, we are better prepared to understand rational 
or scientific therapeutics as taught by his followers. 

4. HomcEOPAThy is a mode of treating diseases by the 
administration of medicines which are found capable of 
exciting in healthy persons symptoms closely similar to those 
of the disease of the patient under treatment. 

Homoeopathy is a system of medicine introduced into 
practice about 1790 by a German physician named Samuel 
Hahnemann. It is founded on the belief, that medicines 
have the power of curing morbid conditions similar to those 
conditions which they have the power to excite ; expressed 
in Latin by the phrase, ' ' Similia similibus curantur" and in 
English by " like cures like." That diseases are cured by 
substances which produce in persons in health symptoms 
like those presented by the patient, has been from the earliest 
times a recognized fact, both by medical writers and poets, 
who have expressed the prevailing belief of the ages in which 
they lived. Among the former we find the author of a treatise 
generally ascribed to Hippocrates, entitled : " On the Place in 
Man." This writer gives numerous examples of what may 
be called homoeopathic cures; and recommended for the cure 



THEORY AND PRACTICE OF MEDICINE. II 

of mania this remarkable prescription : " Give the patient a 
draught made from the root of mandrake, in a s?naller dose 
than sufficient to -produce mania" You must not lose 
sight of the fact that this is the language of one who is claim- 
ed to be the "father of scientific medicine." The works of 
the poets abound with illustrations of this belief. Probably 
the oldest expression of it is in some lines ascribed by Athe- 
nseus to Antiphanes, B. C. 404, thus translated: 

"Take the hair, it is well written, 

Of the dog by which you' re bitten, 
Work off one wine by his brother, 
And one labor with another." 

Shakespeare, in Romeo and Juliet, expresses the same 
maxim : 

"Tut, man ! one fire burns out another's burning; 
One pain is lessened by another's anguish, 
Take thou some new infection to the eye, 
And the rank poison of the old will die." 

Milton, in the preface to Samson Agonistes, gives his 
version thus : "In physic, things of melancholic hue and 
quality are used against melancholy, sour against sour, salt to 
remove salt humors*" etc. Thus there has always been a 
vague tradition that medicines sometimes cured diseases 
similar to those they caused. 

But it was reserved for Hahnemann to propound the 
startling dogma, not only that medicines did occasionally 
produce such cures, but that true direct, and radical cures 
could be effected only by recognizing this principle as the 
guide for the selection of the right remedy in any given 
morbid condition of the system He engaged his friends and 
disciples in the task of procuring data on which to proceed in 
'reducing his rule to practice. They took given quantities of 
the substance which was the subject of experiment, and each 
kept a record of the effects that it produced. The various 
records thus obtained were submitted to Hahnemann, who 



12 THEORY AND PRACTICE OF MEDICINE. 

compared them together, and with his own observations on 
himself, and out of the results thus obtained, compiled what is 
named a proving of the medicine. Hahnemann lays it down 
as one of the fundamental propositions of homoeopathy, that 
no medicine should be given to the sick which has not first 
been proved upon those of health. He devoted himself to 
this task, and has left ten volumes of such provings ; out of 
this work the various abridgments in popular use in this and 
other countries have been derived. The properties once 
determined, then it becomes possible to administer it in 
accordance with the principle of homoeopathy. To do so, 
however, it is requisite that the medicine should be given by 
itself. Thus the second proposition of Hahnemann's system 
is, that only one medicine should ever be given at once. 

To ascertain the effects of medicinal substances on persons 
in health — from the knowledge thus obtained to select a 
remedy whose action corresponds with the symptoms of the 
patient under treatment — to give this remedy by itself alone 
are three of the fundamental rules for the practice of homoeo- 
pathy. The fourth is that the dose of a homoeopathic medi- 
cine should be so small as not to cause any general disturbance 
of the system, its action being limited to that portion of the 
body which is in a morbid condition. How small that is, can 
be ascertained only by experiment. Hahnemann pointed out 
that the amount of the effect of a medicinal substance depends 
upon two conditions ; first, the medicinal form in which it is 
administered ; second, the state of the body of the person who 
takes it. 

For example, a hard pill of belladonna of five grains swal- 
lowed by a robust and healthy man may be followed by only 
trifling symptoms ; but let that pill be dissolved in a pound 
of water, and an ounce of the solution be given every hour, 
then will ensue well marked symptoms of the poisonous 
action of the drug. But if, instead of administering it to 
a person in health, it be given to one who is suffering from 
such an inflammation of the tonsils as belladonna produces, 



THEORY AND PRACTICE OF MEDICINE. 1 3 

then it will be found that the inflamed tonsils will be most 
acted upon by their specific irritant. Disease implies a 
preternatural sensitiveness. An inflamed eye cannot bear 
light, an inflamed stomach cannot bear food, and every diseased 
organ is powerfully affected by the particular substance, which 
has, in its physiological operation, a close affinity with the 
character of the morbid condition in which it is at the time 
when its specific medicine is administered. 

"The following," says Hahnemann, "are examples of 
homoeopathic cures performed unintentionally by physicians 
of the old school of medicine : 

" The author of the fifth book, attributed to Hippocrates, 
speaks of a patient attacked by the most violent cholera, and 
who was cured solely by white hellebore, veratrum album, 
which, according to the observations of Forestus, Ledelius, 
Reimann, and others, produces of itself a kind of cholera. 

"It is claimed that in the homoeopathic system of practice, 
the selection of the medicine is made according to a simple 
rule based on a law of nature, while in all other systems there 
is necessarily more or less empiricism and uncertainty. This 
natural law is that the introduction of any poisonous drug 
into the animal organism gives rise to two series of effects 
which are opposite in character. Thus aconitum produces 
chilliness, tingling, numbness, weakness and fever ; but fol- 
lowed by heat flushings, and general physical and mental 
excitement." (Alden's Encyclopedia.) 

I have thus given a partial history of medicine from 
allopathic and scientific writers, and after a careful survey of 
the whole subject, the question arises which of the schools of 
medicine, if not the homoeopathic, is strictly entitled to the 
distinction of scientific. For while the medical profession, 
as a whole, was floundering in the quicksands of doubtful 
experimentation and uncertainty as to whether eclectic, anti- 
pathic or allopathic medication was the true method, Hippo- 
crates introduced the idea of homoeopathic therapeutics, as a 
comparison between the other systems he had already sug- 



14 THEORY AND PRACTICE OF MEDICINE. 

gested, and which no doubt was practised by many, though 
ignorant of the name and the law which was reserved for 
Hahnemann to fully develop into a science. 

After thirty-eight years of almost continuous practice, and 
twenty years of that time as an allopath, I wish to emphasize 
the fact that, in all diseases, if medicine performs a cure, it 
does so homceopathically, whether prescribed by an allopath, 
eclectic or a homoeopath. It is true that opium and other 
anodynes may relieve pain and for the time being suppress 
disease, but they never cure unless they are homoeopathic to 
the particular case for which they are prescribed. That is to 
say, if opium is homoeopathic to the particular pain then it 
cures ; if not, it only holds the pain in abeyance until nature 
performs a cure. While that is true, yet the large doses of 
crude opium may do irreparable damage to the nerve centers. 
That being true, then why not select a suitable homoeopathic 
remedy for each case, and thus avoid a*ny danger. 

Opium cures that form of diarrhea which it produces in 
over-doses. That is to say, the primary effect of opium is 
constipation and its secondary action produces diarrhea. If 
you have a case of diarrhea of the same or similar character 
as that produced by opium, then that drug potentized will 
cure the case. 

Veratrum viride is almost specific in the cure of pneumo- 
nia, because, in over-doses, its primary effect on a healthy 
lung is to produce congestion and inflammation of that organ. 
While an allopath I had splendid success in the treatment of 
pneumonia with tincture of veratrum viride. But I was not 
aware that I was curing my patients homceopathically until 
after I became a homoeopath. I then learned that by giving 
too much of the medicine I prolonged the cure from seven to 
fifteen days, but now by giving it homceopathically I cure 
uncomplicated cases in two to seven days. 

If you have a case of chill and fever that is similar to that 
produced by quinine, then that drug in minute doses will 
certainly cure the case. But if not homoeopathic to the par- 



THEORY AND PRACTICE OF MEDICINE. 1 5 

ticular case on hands, then no amount of the crude material 
will cure. 

I have been able to treat cancer and all incurable and pain- 
ful diseases with homoeopathic remedies more successfully than 
I did with opium and other anodynes while I was an allopath. 
I am conscientious in my devotion to homoeopathy, for the 
practice is safe, speedy and satisfactory. 

While I now differ from my allopathic brethren as to the 
best method of prescribing for the sick, yet candor compels 
me to say that no profession can produce more learned and 
scientific men than are to be found in the allopathic school. 
Every branch pertaining to medicine taught by them is on a 
strictly scientific basis, except their therapeutics. I am glad, 
however, to notice that they are approaching nearer the true 
science every year, as is evidenced by Bartholow's and 
Ringer's Therapeutics, which are in a measure copied from 
homoeopathic works. 

While the homoeopathic profession has fewer in number, 
yet they are the peers of their allopathic brethren in educa- 
tion and scientific attainments. In fact, so far as medical 
education is concerned, many homoeopaths are superior to the 
allopaths. For the former study all that is taught in the 
best allopathic colleges, and homoeopathic materia medica 
and therapeutics beside, which, combined, is the key note to 
the scientific art of healing. 

Thus it seems to me that from a common sense view of 
the history of medicine, and a scientific standpoint, you can 
readily see the superiority of homoeopathy over all other 
schools of medicine without further experimentation. 



THEORY AND PRACTICE OF 
MEDICINE. 



In taking up the study of the principles and practice of 
medicine, it will be necessary for us to take a brief survey of 
some of the outlines and aids furnished us by anatomy, 
physiology, and pathology. Indeed, we must be familiar 
with the elementary principles of these branches in order to 
prosecute the study of disease and its treatment with satisfac- 
tion and success. As you complete the study of each of those 
elementary branches you approach one step nearer the practice 
of the healing art. And just in proportion to your knowl- 
edge of each of those branches will be your ability to trace the 
cause of disease, diagnosticate correctly, and treat it scientifi- 
cally and successfully. 

It is by anatomy that you learn the names, form and 
position of the various organs and tissues of the human body. 
And in order to assist you in your investigations, and to 
make a correct diagnosis of the parts affected, the body is 
naturally divided into three great internal cavities, called 
the cerebro-spinal, thorax, and abdomen. 

The cerebro-spinal cavity contains the brain, spinal cord 
and their meninges. The thorax, or chest, contains the 
lungs with their serous coverings ; the heart enclosed in its 
pericardium ; the aorta and other great vessels, and the 
oesophagus. The abdominal cavity is separated from the 
thorax by a muscular septum called the diaphragm. 

To assist in tracing the boundaries of the viscera, the 
abdomen is divided into regions bv imaginary lines. Thus, 



THEORY AND PRACTICE OF MEDICINE. 1 7 

if a line be drawn around the body parallel with the cartilages 
of the ninth rib, the second on the last short rib, and an- 
other one parallel to the first, drawn around the lower part 
of the abdomen, so as to touch the upper crest of the ilia, we 
then have the abdominal cavity divided into three zones. 
Now then, if we let two lines fall from the cartilages of the 
eighth rib on either side perpendicular to the former, and 
extend to the middle of Popart's ligament, you will divide 
each zone into three parts ; consequently the abdominal cavity 
will be divided into nine regions, named in the following 
order. The upper and central region is called the epigastric ; 
from two Greek words efi, over, and gaster, the stomach. 
Those regions upon either side of the epigastric are called the 
right and left hypochondrium. 

The central region of the middle zone is the umbilical, 
from the fact that it contains the umbilicus. On the right 
and left of this are the right and left lumbar. The region 
immediately below the umbilical is the hypogastric ; from 
hwpo, under, and gaster, the stomach — under the stomach. 
Upon either side of the hypogastric are the right and left 
inguinal or iliac regions. 

When the viscera of the abdomen are in their normal 
condition, you will find them situated as follows : The 
stomach is situated, principally, in the epigastric, but extends 
partly into the left hypochondrium. The epigastric region 
also contains the left lobe of the liver and lobus spigelii, a 
part of the aorta and thoracic duct. The left hypochondrium 
contains, in addition to the splenic end of the stomach, the 
spleen, pancreas, and upper half of the left kidney. The 
right lobe of the liver and gall-bladder, the duodenum, upper 
part of the right kidney, and the hepatic flexure of the colon, 
are situated in the right hypochondrium. The transverse 
colon, the mesentery, transverse portion of the duodenum, 
and a few folds of the jejunum and ilium are found in the 
umbilical region. The ascending and descending colon, and 
lower part of the right and left kidneys, and a few folds 



1 8 THEORY AND PRACTICE OF MEDICINE. 

of the small intestines are found in the lumbar regions. 
The hypogastric region contains convolutions of the small 
intestines, the bladder and uterus. It is, however, only when 
the bladder and uterus are distended that you can detect 
them in this region ; ordinarily they rest deep in the pelvis. 
The right inguinal or iliac region contains the coecum or 
appendex, ureter and spermatic vessels. The left contains 
the sigmoid flexure of the colon, left ureter and spermatic 
vessels of the left side. 

By understanding the anatomy and physiology of those 
parts you can readily detect any pathological change that 
may have taken place, or that may be going on at the time of 
your examination. I have already stated that the bladder is 
not found in the hypogastrium unless distended with urine ; 
so if you detect a large swelling above and in the center of 
the pubes you may readily infer that your patient is suffering 
from retention of urine. If the patient be a female you will 
have to diagnose between a distended uterus and bladder. 
This you can readily do by introducing a catheter into the 
bladder and by a digital examination of the uterus. 

If you discover a fullness below the margin of the ribs in 
the left hypochondrium, you will generally find it to be 
caused by an enlargement of the spleen. Thus you may 
trace the anatomical and pathological relations and conditions 
of all the viscera contained in the different regions of the 
body. A thorough knowledge of those regions and their 
contents are indispensable, both to the physician and surgeon. 

I now call your especial attention to a subject of the 
highest importance to the practitioner of medicine. I refer 
to the portal circulation. It is a subject that is often over- 
looked by a majority of students as of little importance. But 
let me assure you that the successful action of many of your 
agents and nutritious materials depends upon the condition of 
that viscus. 

You are aware that the portal system consists of four 
veins, named the inferior mesenteric, superior mesenteric, 



THEORY AND PRACTICE OF MEDICINE. 1 9 

splenic, and gastric. They collect the venous blood and a 
large share of the nutritious materials from the organs of 
digestion and convey them through the liver. These veins 
unite just above and behind the border of the great end of 
the pancreas and form the portal vein. The portal vein 
divides into two branches at the transverse fissure, and ac- 
company the hepatic artery and hepatic duct through the 
substance of the liver. If you study carefully the physiology 
of the portal system, you will readily understand why it is 
that it bears such an intimate relation to the health and life 
of the individual; and why it is, pathologically considered, 
the most interesting part, to the therapeutist, of the animal 
economy. The capillaries of the portal system are spread 
throughout the alimentary canal, and absorb every thing that 
is taken into the system except the chyle. Albuminoid sub- 
stances are digested in the stomach, and are principally 
absorbed by the capillaries of the gastric portion of the 
portal system of veins. Sugar and starchy substances are 
digested by the intestinal juices, and are absorbed by the root- 
lets of the superior and inferior mesenteric portal veins. Oils 
and fats are digested by the pancreatic fluid, and are taken up 
by the lacteals. The contents of the portal system are con- 
veyed through the liver, where they undergo a catalytic 
change before entering the general circulation. 

In view of this physiological arrangement, you can readily 
see how important the portal system is to the health and 
growth of the body ; and how necessary it is that you under- 
stand the physiology of that system so as to be able to detect 
any pathological change that may take place in those parts 
with which it is so intimately connected. 

If the stomach is congested, or inflamed, it is evident that 
the albuminoids cannot be digested, and consequently the 
system must suffer for want of that material. Then again, if 
the intestinal mucous membrane be inflamed, there can be no 
absorption of the saccharine substances ; and if the mesen- 
tery be diseased the lacteals are unable to absorb the oils and 



20 THEORY AND PRACTICE OF MEDICINE. 

fats ; and thus there will be a failure of assimilation, and the 
patient will die from inanition, unless the difficulty is sought 
and removed. A correct knowledge of the portal circulation 
and the relation it sustains to the therapeutic action of medi- 
cines is indispensable to the successful treatment of disease. 

To illustrate this subject, suppose that you have a pathol- 
ogical condition of the kidneys, which you wish to overcome 
by the diuretic effect of mineral waters ; but according to a 
physiological arrangement the diuretic must first be taken up 
by the portal veins and pass through the liver into the general 
circulation before it can reach the kidneys. Now then sup- 
pose that there is a general congestion of the portal system 
or simply a congestion or inflammation of the liver, what 
would be the result ? Evidently your diuretic and nutriment 
can not reach the kidneys and general circulation only in a 
minute quantity, if at all, and consequently can have but 
little or no effect. Therefore, your first object must be the 
removal of the obstruction, and then you can administer your 
nutritious materials and diuretic with a hope of success. 
Babies often die from inanition from this cause. 

It is, probably, seldom that we find the portal system in 
the condition just mentioned. But that it is often in such a 
morbid state as to retard the free absorption and energetic 
action of nutriment there is no doubt. And hence it is that 
our remedies so often fail to accomplish that for which they 
are given, if we fail to diagnose correctly, for there is such a 
thing as symptoms from reflex action. 

After you have studied the position, size, attachments, and 
relations of the organs and tissues, your next step of investi- 
gation is to examine the histological and microscopical 
elements of which they are composed. And when you have 
become familiar with their functions or physiological actions, 
you will then be prepared to understand something about the 
abnormal functions of the tissues or their pathology. 

Pathology may be termed diseased physiology, for it treats 
of morbid actions of the organs and tissues. For many years 



THEORY AND PRACTICE OF MEDICINE. 21 

pathologists believed that the fluids were the seat of disease 
and when the solids were diseased it was communicated to 
them from the fluids. 

Consequently, humoral pathology was the doctrine of the 
medical schools for ages ; and hence their great mania for 
blood-letting, hoping thereby to draw off the disease with the 
blood. The medical profession, however, became convinced 
that humoral pathology was running to extremes, and they 
turned their attention to the solids, and fancied that they de- 
tected the great error of the humoralists, and in their zeal for 
solidism they ran to the opposite extreme. The truth lies 
between the two extremes. It is now a demonstrated fact 
that disease may originate in the fluid, and be communicated 
to the solids, and vice versa. 

I now direct your attention for a few moments to the 
blood. The blood, as you are aware, is the moving element of 
the circulatory system ; and controls the secretory and excre- 
tory functions. It carries alike the nutritious materials to 
nourish the tissues and organs of the body, and also the 
deleterious and effete matter, which enters the system from 
without, or that is formed within. But amid these compli- 
cated phenomena you will observe the wise provisions made 
by nature for purifying and cleansing the system of those 
materials which are deleterious, and unfit for assimilation. 
The kidneys, the skin, the lungs, and the biliary ducts 
are all Nature's agencies by which to free the system of 
impurities. 

A conglomerated mass of material is poured into the liver 
from the organs of digestion by the portal system of veins ; 
and there, in the lobules of that organ, these elements are 
freed from much of their impurities by the lobular biliary 
plexus, and are thus, in a measure, purified and fitted for 
nourishing and building up the tissues and organs for which 
they were intended. 

It is a wise and beautiful provision of nature, that each 
organ and tissue has the inherent property of selecting from 



Normal Elements 

of Blood. 



22 THEORY AND PRACTICE OF MEDICINE. 

the circulating fluid, as it traverses their meshes, the mate- 
rials that are appropriate to their wants or condition. And 
the excretory organs act as faithful sentinels in protecting 
the system, and warding off disease, by collecting the effete 
and excrementitious matter and casting it out of the system. 
The blood, after passing through the refining process, is 
found to contain the following normal elements : 

Albumen, 

Fibrin, ' 

Red Globules, or Corpuscles, 

White Globules, or Corpuscles, 

Salts, 

Extractive Matter, 

Fatty Matter, 

Water. 

These elements all fulfill their mission in supplying the 
tissues, and keeping the blood in a rich and healthy condi- 
dition. But some of these elements, after performing their 
office, are no longer fit for use and are cast out of the system 
as excrementitious matter. To this class belongs the follow- 
ing : 

Fibrin, 

Extractive Matter, 
Excrementitious Elements. ■< g a j ts 

Water. 

Fibrin is necessary in the blood to hasten its coagulabil- 
ity in case of wounds, to prevent hemorrhage ; and there are 
many other pathological conditions of system that would be 
difficult to overcome was it not for the aid furnished us 
by the fibrin of the blood. 

Blood contains about three to four parts of fibrin in 1,000 ; 
that amount seems to be necessary to constitute healthy 
blood, and the excess is thrown out of the system. All that 
you have to do to prove this fact, is to extract blood from 
the renal artery of one side before it enters the kidney, and 
from the renal vein of the other after leaving the same. 
Upon examination it will be found that the former contains 



THEORY AND PRACTICE OF MEDICINE. 2$ 

twice as much fibrin as the latter ; thus showing that the blood 
had parted from half of its fibrin in passing through the 
kidneys. 

In all inflammatory fevers, where the excretions are 
checked, the fibrin of the blood is greatly in excess. While 
in all non-inflammatory diseases it is diminished because the 
functions of the excretory organs are normal. To obtain 
pure fibrin, recently drawn blood may be stirred with a bun- 
dle of twigs, which collect the fibrin in their meshes. The 
twigs are afterwards washed in clean water to free the fibrin 
from the coloring matter of the blood. 

The water and salts of the blood are important elements ; 
indeed, we could not exist without them. And yet if they are 
retained in the system beyond a certain amount they become 
deleterious ; exosmosis is increased, endosmosis is diminished, 
and dropsy is the result. 

The red corpuscles are the life-giving principle of the 
blood ; they give tone and vigor to the whole system ; they 
are the principal stimuli and excitors of the nervous centers. 
When the}' are deficient the skin looks pale and unhealthy ; 
the eyes lose their lustre ; the energies and mental faculties 
are torpid ; and a condition is developed which we call 
anemia. But, on the other hand, if they are too rich, or 
abundant, we have an opposite condition called hyperemia, 
plethory, or a fullness of blood, which may be the exciting 
cause of congestion and inflammation. 

I now invite your attention to the elementary properties 
of the tissues, which are classified as follows : 



Elementary Properties. 



Irritability, 

Sensibility, 

Susceptibility, 

Contractility, 

Tonicity. 

Vital Affinity. 



These are the normal properties of the organic elements 
of the tissues of the human body ; and it is by the excessive 



24 THEORY AND PRACTICE OF MEDICINE. 

exaltation, or diminution of some of these properties, that 
gives character to the two grades of disease known as sthenic 
and asthenic. 

Sthenic comes from sthenos, which means strength. It is 
a term expressive of organic excitement ; and is therefore 
used to express the character of those diseases which are 
produced by accumulated excitability. Asthenic is the re- 
verse of sthenic, and means a want of strength. It is applied 
to all diseases that are characterized by debility. 

Irritability comes from irrito, to provoke. It is that 
inherent vital property of the elementary tissues, which 
causes them to respond to certain stimuli. That stimuli are 
the fluids of the body, and that peculiar nervous influence, 
which, for a want of a better name, may be termed animal 
electricity. If the property of irritability is much increased 
it causes excitability of the system, and, therefore, gives 
character to that form of disease known as the sthenic grade. 
But, on the other hand, if the irritability of the tissues is 
reduced below the normal standard, the organs and tissues 
are relaxed ; debility is induced ; and if fever and inflamma- 
tion are developed they are said to be of a low or asthenic 
grade. Irritability is essential to the healthy function of the 
organs. The irritability of the heart is promoted, both by 
the stimulus imparted to its fibers by the blood, and by 
nervous influence ; but if that irritability be increased or 
diminished beyond a certain point, a pathological change will 
be the result. 

Susceptibility, or the property of responding to an impres- 
sion, is an important function of the tissues ; but if it be 
either increased or perverted, then the organic elements 
readily succumb to disease. 

Tonicity is that property through which the animal 
organism responds to the stimuli of the blood, by which their 
tone is kept at a normal standard. 

Vital-afhnity is the bond of union between the organic 
substances ; and when that tie is weakened, or severed, dis- 



THEORY AND PRACTICE OF MEDICINE. 25 

integration takes place, tonicity is destroyed, sensibility is 
perverted, and irritability gives place to anesthesia and death. 

The origin of organic matter, out of which the elementary 
tissues are formed, is derived from the laboratory of the 
living cell ; and each atom and fiber is endowed with that 
vital or living principle, which causes them to respond to 
that stimuli which are adapted to their wants and peculiarities. 

It is a remarkable phenomena, in the laws which govern 
those tissues, that each one has the property of selecting, 
from the heterogeneous mass floating in the blood, the mate- 
rials intended for its nourishment and development. 

The elementary tissues of the animal organism, and their 
primary functions, may be seen at one view in the following 
table : 

PRIMARY FUNCTIONS. 

Nerve { Sensibilit y- 

\_ Transmissibility. 

^ ™ Muscular — Contractilty. 

Elementary Tissues. < t^., t., . .^ ' 

r ibrous — Elasticity. 

Vascular — Circulation. 

Secreting — Secretion. 

Ths principal exciters of these tissues are oxygen and 
caloric. The blastema, or germ, is first excited to action in 
the ovum by these agents, and it is nourished and brought 
into existence by them. Caloric, in certain proportions, 
causes the germ to expand, and while in that expanded state 
oxygen enters and excites it to action and development. If 
caloric is in excess the germ is so rapidly expanded that its 
fibers are broken and it dies. 

Pure air, regular exercise, and a nutritious diet, are neces- 
sary for a proper supply of these ingredients in the animal 
economy. If they are deficient, the living cells of which the 
germ is composed in the seminal fluid, may be devoid of that 
living or vital power which constitutes healthy matter. 

This want of vital force, in both the male and female, may 
become so deficient, that the germ can amount to nothing 



26 THEORY AND PRACTICE OF MEDICINE. 

more than the tubercles thrown from the lungs in con- 
sumption. Or this vital force of the cells may be only 
partially impaired in one or both parents, and vitality enough 
left to cause the germ to expand, and a living being is 
developed to inherit the predisposition or diathesis of the 
parent or parents to certain forms of constitutional diseases. 

The anatomical elements having been collected for the 
structure of the human mechanism, and those elements having 
been endowed with their vital functions, the great panorama 
of the formation and propagation of the human species, is 
spread out before you, and portrays to your vision the histo- 
logical elements passing in the field of the microscope, and 
hastening to one common center — the laboratory of the living 
cell. 

Within that cell you behold the miniature of a perfect 
organism, which expands by fixed and unalterable laws, until 
at last you see passing before you a living, acting, and think- 
ing being ; perfect in all of its parts, and thus should have 
remained for ever, had it not been for the penalty of that 
transgression, which caused the sentence to go forth : "In the 
day thou eatest thereof thou shalt surely die." 

I desire to call your attention to an exceedingly interest- 
ing subject, wdiich pathology has brought to light ; and it is 
one that demands your careful consideration. It is a subject 
that when fully understood will simplify the practice of med- 
icine, and benefit suffering humanity. I refer to those con- 
ditions of the system which have been termed diatheses. 

DIATHESES. 

By diathesis we understand that condition of the system 
which modifies the cause, and controls the result of patholog- 
ical changes, and predisposes to certain forms of disease. 

The term has long been used to explain those states of 
system known as the rheumatic, tubercular, and gouty diath- 
eses. That is to say, the system may be in that condition 



THEORY AND PRACTICE OF MEDICINE. 2 J 

which predisposes to rheumatism, phthisis pulmonalis, scrof- 
ula, and gout, when the exciting causes are brought to bear 
upon the patients. But there are other conditions of the sys- 
tem, independent of these hereditary constitutional diatheses, 
to which I now more particularly refer, and which are predis- 
posing causes of pathological changes. These states of sys- 
tem are known as the aplastic, the plastic, and the hyper- 
plastic diatheses. These terms have been chosen to represent 
the normal condition of system, and the limits of the two 
extremes to which pathological change may transgress physi- 
ological laws, before lesion takes place ; or that condition 
supervenes which is called disease. 

I propose : i. To inquire into the nature of these dia- 
theses, or point out those conditions of the system which are 
entitled to these appellations. 2. What relation they sustain 
to diseases, or how far they modify the course and termination 
of each particular affection. 3. How we are to correct these 
diatheses, and thus ward off fatal results by the supervention 
of zymotic and inflammatory diseases. 

APLASTIC DIATHESES. 

Of the three diatheses, the aplastic is the one that should 
engage the especial consideration of the surgeon and practi- 
tioner of medicine. For it is the one that thwarts the 
intentions of the former in his operations, controls the reme- 
dies of the latter, and frequently destroys the life of the 
patient. In that condition of system known as the aplastic di- 
athesis, the blood is impoverished, susceptibility is increased, 
vital affinity is impaired, tonicity is diminished, and the fluids 
undergo a chemical change ; and upon the accession of an 
inflammatory process, the proteine compounds are liquefied, 
and the tissues readily break down and degenerate into pus. 
Or, in other words, surgically speaking, the aplastic diathesis 
is that condition of system in which the blood is deficient in 
that plastic material which nature has provided for the repair 



28 THEORY AND PRACTICE OF MEDICINE. 

of injuries and the growth of the tissues. In this condition 
the system is said to be incapable of resisting the invasion 
and influence of zymotic agents, and of overcoming patholog- 
ical changes. If this be the condition of the system in the 
aplastic diathesis, it becomes a matter of great importance, 
practically, to be able to tell what element it is that produces 
such morbid changes in the animal economy. 

Physiological chemistry has already demonstrated the 
facts that soda and ammonia are the liquefiers of the albumi- 
noid substances ; and that the alkalies are capable of breaking 
down animal tissues. Clinical observation has shown that 
the tissues and fluids of an aplastic patient are strongly alka- 
line ; or at least they are morbidly changed, and have a strong 
affinity for the alkalies. It has also been demonstrated that 
by crowding patients with suppurating wounds into badly 
ventilated hospitals ammonia is evolved ; and it only requires 
a few days to bring all of the patients in the ward into the 
aplastic diathesis ; and thus render them fit subjects of ery- 
sipelas, pyemia, and other zymotic diseases. . Therefore, we 
necessarily come to the conclusion that this tendency of the 
fluids to alkalinity is the cause or condition favorable to the 
development of the aplastic diathesis, and that the suppura- 
ting tendency of that diathesis is due to the action of the 
alkalies on the proteine compounds of the body. These facts 
having been demonstrated, and the character of the aplastic 
diathesis having been established, we can readily see what 
the result would be to the patient upon the reception of 
wounds, or the supervention of disease. We can also trace 
the relation that this diathesis sustains to disease, and under- 
stand how far it modifies the course and termination of each 
particular affection. 

There are, generally, two elements combined in idio- 
pathic diseases, which give to these affections their charac- 
teristics, control their progress, and shape their results. 
These elements are a zymotic agent and the aplastic diathe- 
sis. The former is the germ of disease, now called bacilli, 



THEORY AND PRACTICE OF MEDICINE. 29 

while the latter is the fruitful soil in which it germinates, and 
produces all the fearful results that follow in the train of 
epidemics. Without the aplastic diathesis, epidemics will 
make but a feeble progress,, and zymotic diseases can hardly 
exist in the human system. 

If it be true that these two elements hold the issues of life 
and death under their control, it becomes a matter of the 
highest importance that we be able to distinguish their 
presence, and to know how to stay their progress. In order 
that we may understand the subject fully, it may be well for 
us to examine the class of affections that are usually influ- 
enced by the aplastic diathesis. 

All diseases may be classified under three grand divisions, 
viz. : 1. Idiopathic fevers ; 2. Constitutional diseases ; and 
3. Local diseases. Idiopathic fevers are again subdivided in 
accordance with their known and supposed causes, and their 
peculiar characteristics. We have continued fevers, period- 
ical fevers, and eruptive fevers. Some of the continued 
type of fevers are supposed to be caused by a zymotic 
agent, whose origin is derived from decomposing animal mat- 
ter. This leaven, or bacterium, whatever may be its char- 
acter, requires a certain condition of system for its devel- 
opment. That condition, without doubt, is the aplastic 
diathesis. 

Periodical fevers are said to be produced by decomposition 
of vegetable matter under certain geological and atmospheric 
conditions. They differ from the continued type both in 
their origin and phenomena. 

The exanthematous type of fevers differ from the other 
two varieties of idiopathic diseases, in view of the fact that 
they are usually propagated by the communication by contact 
of a specific animal virus. Each disease furnishes its own 
germ or ferment, which retains a fac-simile of the original 
affection. These poisons, when introduced into the aplastic 
system, act as a leaven and continue to spread until the whole 
is leavened. 



30 THEORY AND PRACTICE OE MEDICINE. 

Clinical experience has pretty well established the fact, 
that nearly all diseases belonging to the idiopathic type are 
dependent upon zymotic agents for their origin ; and upon 
the aplastic diathesis for their development and propagation. 
Intermittent fever seems to form an exception to this rule. 
For while it is evident that the disease is of zymotic origin, 
it often affects the plastic as well as the aplastic patient. In 
the former condition, the tendency of this disease is to pro- 
duce enlargement of the liver and spleen without disinteg- 
ration of tissue. While in the latter, these organs are liable 
to become softened and disintegrated. And when death does 
occur from this fever it is due to the effect of the morbific 
agent upon the system acting through the aplastic diathesis. 

Many of the idiopathic fevers are self-limiting ; that is to 
say, they run a certain course, or pass through certain well- 
defined stages, before they disappear from the system. The 
severity of these stages is dependent upon the degree of 
aplasticity of the patient. 

Of the constitutional diseases, rheumatism and gout are 
peculiar to the hyperplastic diathesis. Indeed, they cannot 
exist in any other condition of system. A patient with the 
rheumatic diathesis may become plastic, or aplastic. But 
rheumatism and gout will never affect him until he becomes 
hyperplastic. Or in other words until there is an excess of 
acid in the system. „ 

Local diseases may occur in any condition of the system. 
But whatever may be their direct cause, it is certain that the 
aplastic diathesis controls their action ; and wields a mighty 
influence for harm to the patient. 

The leaven of a disease is always the same. Its activity 
and power of communicability may be impaired, but it mani- 
fests its degree of virulency in proportion to the aplasticity of 
the blood. For example, variola may be distinct in one 
locality and the virus may be carried into another, and 
prevail as confluent or malignant ; thus demonstrating the 
different phenomena produced by the same leaven. The 



THEORY AND PRACTICE OF MEDICINE. 3 1 

degree of confluence, or malignancy, will always be in pro- 
portion to the aplasticity of the patient. 

To further illustrate this subject, I may remark that we 
have three varieties of scarlet fever, wdiich are known as scar- 
latina simplex, scarlatina anginosa, and scarlatina maligna. 
Are we to understand by this, that there are three forms of 
scarlatina virus, which produce similar effects but different 
results ? Or will it not be more in accordance with scientific 
investigations and clinical experience, to say that the virus is 
the same ; but the difference, in the phenomena of the disease, 
is due to the degree of aplasticity of the patients ? We may 
site as evidence of this fact, that one member of a family may 
die of malignant scarlet fever, while the others may have the 
simple variety from the same cause, at the same time, and 
yet all recover. 

Scarlet fever may prevail sporadically or epidemically. In 
the former, the diathesis is regulated by local causes, while in 
the latter it is controlled by atmospheric or epidemic influ- 
ences which precede or accompany the spread of the morbific 
agent. 

When any of the exanthematous diseases attack an aplastic 
patient they are liable to assume different forms correspond- 
ing to the degree of aplasticity of the system and to put on a 
low grade or assume a malignant type. Hence it is that we 
often hear persons speaking of black measles and black small- 
pox. The reason that some persons are not susceptible of the 
virus of small-pox, vaccinia, and other contagious diseases, is 
owing to the hyperplastic condition of the system. We often 
see persons who have small-pox and other exanthematous 
diseases so mildly that they never give up their avocations 
during the attack. This goes to prove that those patients 
were lingering so near the confines of the aplastic diathesis 
that they were not wholly protected, and yet there was not 
plasticity enough to ward off the disease entirely, and not 
aplasticity enough in the system to cause the disease to 
become fully developed. The different varieties of modified 



32 THEORY AND PRACTICE OF MEDICINE. 

small-pox, known as horn-pox, wart-pox, and crystalline pox, 
are only evidences of the phenomena of small-pox virus acting 
on different degrees of the plastic or hyperplastic diathesis. 
It must, however, be borne in mind that the individual who is 
not susceptible of contagious virus at one time on account of 
his hyperplastic state, may, from local causes, in a short time so 
change his diathesis as not only to become the subject of con- 
tagion, but the disease may even assume a malignant form. 

I may remark that while the terms aplastic, plastic, and 
hyperplastic, have been chosen to represent the three im- 
portant conditions of system, yet there are different degrees or 
stages of development in each. The condition of system 
which barely tolerates the presence of an idiopathic disease, 
is the lowest degree of that state of the system which is 
termed plastic. And this degree marks the boundary between 
the plastic and the aplastic diathesis. From this point the 
system may rise from one stage of development to another 
until it reaches that degree of plasticity which is compat- 
ible with perfect health. Beyond this point it is difficult 
to tell where the plastic diathesis ends or the hyperplastic 
begins, except by an analysis of the fluids of the body. On 
the other hand, we have all grades of aplasticity from that 
condition in which the fluids become alkaline, and the skin 
gives evidence of a few festering pimples, up to that degree 
in which the tissues are ready to dissolve into pus at the 
approach of inflammation, or upon the introduction of the 
smallest amount of the erysipelatous virus. 

The aplastic diathesis is a controlling element for harm in 
all diseases and surgical operations. It is the medium through 
which contagious and epidemic diseases spread from house to 
house, and leave desolation in their march. And it also fur- 
nishes a correct answer to the oft repeated questions, why an 
endemic or epidemic disease is so readily arrested at one time 
by almost any plan of treatment, while at other times the 
same form of disease bids defiance to the best medical skill 
and the most potent agents ? 



THEORY AND PRACTICE OF MEDICINE. $$ 

To my mind, the aplastic diathesis is one of the most 
interesting and important subjects that can engage the atten- 
tion of the medical profession. For it holds the lives of mil- 
lions of human beings in the balance, and the scale is turned 
in proportion to the degree of aplasticity of the patient. 

We cannot account for the fact that one member of a 
family may have an attack of typhoid fever, while the others, 
who were equally exposed to the same typhoid poison, are 
exempt, except on the hypothesis that the aplastic diathesis 
controls the incipiency and progress of zymotic diseases. We 
must not lose sight of the fact that the primary cause of zy- 
motic diseases, and that which induces the aplastic diathesis, 
are entirely different. The former is an ever self-propagating 
animal virus, and the product of vegetable and animal decom- 
position, while the latter is a chemical change of the fluids 
within the body. When a specific virus is introduced into 
the system of an aplastic patient zymosis takes place, and a 
disease is produced corresponding in every respect with the 
original affection from which the virus emanated. 

All diseases which occur in the aplastic diathesis are 
liable to be complicated with the erysipelatous virus. Some 
writers believe that this is the agent which gives to diseases 
their malignancy. That the erysipelatous virus, whether 
acting on the aplastic diathesis alone, or whether complica- 
ting other affections, is capable of producing malignancy of 
the system there is no doubt. But it is also a fact, that the 
zymotic agent of many diseases carries with it its own 
virulency, which will be active or otherwise in proportion to 
the degree of aplasticity of the patient. 

If an aplastic person be inoculated with the virus from 
the cadaver, or with pus from suppurating wounds, erysipelas 
or pyemia, will be the result. This goes to prove that the 
erysipelatous virus derives its origin from the putrefaction of 
animal tissues and fluids. The surgeon has long since learned 
to fear the presence of the aplastic diathesis. But if it be 
accompanied with the erysipelatous virus he stands in dread ; 

3 



34 THEORY AND PRACTICE OF MEDICINE. 

and he dare not lift his knife until he makes a compromise 
with these two elements, or subdues them both. It matters 
not how gracefully he handles his knife, how neat he makes 
his flaps, or how mechanical his dressings are ; so long as 
these two elements are combined against him his best efforts 
will often fail. Those who have studied the diatheses, and 
understand the relation they sustain to diseases and surgical 
pathology, no longer wonder at the great mortality which 
often accompanies the most skillful operations. 

The aplastic diathesis not only increases the virulency, 
and often hastens a fatal termination of idiopathic diseases, 
and retards the healing process in operations and injuries, but 
it is almost an impassable barrier to the resolution of local 
inflammation. Hence it is that so many patients die from 
erysipelas, pyemia, and phlebitis, as the result of suppurating 
wounds, abscesses, and injuries of the veins. It is the pres- 
ence of the aplastic diathesis, and the erysipelatous virus, that 
so often furnish such a fearful array of mortality in camp 
and hospital practice under heroic treatment. 

If it be true that zymotic diseases will hardly attack the 
plastic diathesis, and that erysipelas, pyemia, and phlebitis, 
will scarcely be found in the plastic patient, then how impor- 
tant it is that we understand this fact, and know how to pro- 
mote that condition, and thus stay the ravages of that class of 
affections. If a patient be aplastic, cutting operations seldom 
heal by first intention. A simple wound in this condition of 
system may prove fatal by the rapid disintegration of tissue, 
whereas the same amount of injury, in the plastic state, 
would heal in from thirty to forty-eight hours and leave no 
unpleasant results. 

PLASTIC DIATHESIS. 

This term is used to point out the normal condition of 
system, in which all of the functions of the body are working 
.harmoniously. And where each tissue is endowed with the 



THEORY AND PRACTICE OF MEDICINE. 35 

inherent property of selecting from pnre blood, rich in pro- 
tein compounds, those materials that are adapted to its 
growth and preservation. It may be said to be that condi- 
tion in which there is no conflict between physiological and 
pathological laws. Or it is that state of the system in which 
the plastic element is always ready to perform its physiologi- 
cal functions, and is ever on the alert, in the various avenues 
of the system, to ward off the approach of zymotic agents and 
pathological changes. This it is capable of doing under all 
ordinary circumstances, and it is only when overpowered by 
the causes of aplasticity, and other direct influences, that it 
ever yields and permits disease to invade the system. 

The plastic diathesis, then, is that condition in which the 
fluids of the body are said to be normal, and are capable of 
increasing organic growth, and sustaining the vital functions 
so as to be compatible with health. Or, in other words, the 
plastic diathesis is that perfect condition of system, or the 
salutary mean that separates those extremes, which represents 
a deficiency of organizable material and organic life on the 
one hand, and an excess and exaltation on the other. The 
former is the beginning of that morbid change in the fluids 
and solids, which rapidly passes into that condition called the 
aplastic diathesis. And the latter is that point where the 
blood becomes excessively plastic, and gives to the organiza- 
ble materials an increased vitality. The patient is then said 
to be in the hyperplastic diathesis. 

Thus it will be seen that the two extremes, the aplastic^ 
and the hyperplastic conditions, are abnormal, while the 
plastic is normal, and all departures from this are only so 
many grades belonging to the one or the other of these 
extremes. Now then, if the plastic diathesis represents the 
system in a state of health, it becomes an interesting inquiry 
as to what form of diseases are liable to attack this con- 
dition. I have already intimated that zymotic diseases, as 
a rule, can hardly attack plastic patients. For when the 
leaven is introduced into the svstem it meets no materials 



36 THEORY AND PRACTICE OF MEDICINE. 

capable of inducing zymosis, but it is immediately met by 
an opposing force, and as it passes the rounds of the circula- 
tion it is silently enveloped with plastic lymph and rendered 
harmless, and when it, reaches the eliminative organs it is 
expelled from the system. Or, if the individual be inocu- 
lated by virus from the cadaver, and other poisonous matter, 
a local inflammation is immediately set up in the part, 
and the virus is surrounded by plastic material, made to 
localize itself, and finally it is cast out of the system by 
the formation of an abscess. Or if the patient be nearing, or 
already in the hyperplastic diathesis, the virus with the ex- 
uded lymph is formed into a hard dry scab, which eventually 
exfoliates, and leaves the parts in a healthy condition. This 
would ever be the case if there were no local or epidemic 
causes brought to bear upon the patient so as to change his 
diathesis and prepare the system for the zymotic change. 
If this be true, the important question with the practitioner 
should be, how shall I meet the causes of aplasticity, retain 
the plastic condition, and thus ward off a large class of 
diseases ? 

The plastic patient is liable to local inflammatory affec- 
tions. But so long as his diathesis remains unchanged the 
inflammation generally ends in resolution without damage to 
the patient. The exception to this rule is, that when inflam- 
mation attacks any of the vital organs it may prove fatal by 
arresting the functions of organic life. If a patient in this 
diathesis receives a wound it generally heals by first inten- 
tion. Or if from contact with the atmosphere it should 
suppurate, it does so slowly, and puts on what pathologists 
term a healthy inflammatory process. 

HYPERPLASTIC DIATHESIS. 

In this diathesis we have a condition of system directly 
opposite to that of the aplastic diathesis. For while the 
fluids of the latter are alkaline, and the tissues readily dis- 



THEORY AND PRACTICE OE MEDICINE. $7 

solve into sanies and pus, the fluids of the former are strong- 
ly acid, and there is a tendency to an increased development 
of tissue. The hyperplastic diathesis may be said to be that 
condition of system in which there is an excess of plastic 
material. By this excessive plasticity of the blood, inflam- 
matory deposits are apt to put on an organizable form, and 
promote the development of glandular tumors and morbid 
growths. The acid condition of the fluids and tissues in the 
hyperplastic diathesis, predisposes the patient to inflamma- 
tory diseases. Rheumatism may be taken as a type of the 
affections belonging to this diathesis. It must not, however, 
be inferred that all persons are rheumatic because they are in 
the hyperplastic diathesis, for a person may remain long in 
that condition, and never have rheumatism unless the second- 
ary causes are brought to bear upon him. The fact that 
rheumatism occurs only in the hyperplastic diathesis, and 
that erysipelas occurs in the aplastic, is proof positive, to my 
mind, that the diatheses do shape the prevalence and termi- 
nation of diseases. And it also further demonstrates the fact 
that the two opposite and opposing elements in nature are 
the basis of those diatheses. That is to say, the alkaline ele- 
ment represents the aplastic diathesis and the acid controls 
the hyperplastic. 

When inflammation occurs in the hyperplastic diathesis it 
seldom or never produces suppuration. Wounds and abra- 
sions heal promptly with scarcely the trace of pus. Zymotic 
agents have but little or no power over patients in this 
diathesis. The two elements have almost as much opposing 
force as the positive and negative electricities. 

Erysipelas cannot pervade the hyperplastic diathesis, nei- 
ther can rheumatism exist in the aplastic. But we must 
remember that bad ventilation, unwholesome diet, and a too 
free and long continued use of alkalies, may convert the 
hyperplastic into the aplastic diathesis. And that condition 
which predisposes or induces rheumatism having passed away 
before resolution of the inflamed parts has taken place, ery- 



38 THEORY AND PRACTICE OF MEDICINE. 

sipelas may supervene and produce suppuration. Thus it is 
that we often hear physicians express the opinion that rheu- 
matic inflammation may pass into the suppurative stage. 
This opinion, however, is in direct conflict with the demon- 
strated facts of diatheses. 

Pleurisy may be mentioned as an example of the influence 
of diatheses on pathological changes. If this disease occurs 
in the aplastic state suppuration of the infiltrated product will 
be most likely to occur. But if the disease attack the hyper- 
plastic patient, the exuded lymph will become organized and 
bind down the pleura with adhesive bands. Hypertrophy of 
the valves of the heart is the result of inflammation occurring 
in the rheumatic or hyperplastic diathesis. 

DIAGNOSIS. 

If what has been said upon the subject of diatheses, and 
their influence upon disease, be true, it may be readily seen 
how important it must be to be able to diagnose these condi- 
tions in advance of any operations or plan of treatment about 
to be adopted. 

The aplastic diathesis is easily diagnosed, in view of the 
fact that the fluids of the body are known to be strongly 
alkaline by chemical reactions. Any pimples or abrasions 
on the skin, suppurate in a few hours, and they have 110 incli- 
nation to put on the healing process. If there should be no 
pimples or other evidence of aplasticity about the skin, a 
simple puncture or scratch by the point of a sharp instru- 
ment will develop the condition within twenty-four or thirty 
hours. Or if we are correct in our supposition that zymotic 
diseases are developed by the aplastic diathesis, then the 
presence of any of those diseases is an evidence that the 
patient is already in that condition, or that he is lingering on 
the borders between the plastic and the aplastic diatheses. 

In the plastic diathesis pimples and abrasions on the skin 
dry up in a few hours, and have but little tendency to suppu- 



THEORY AND PRACTICE OF MEDICINE. 39' 

ration. The urine is nearly neutral, acids slightly predomi- 
nating. 

The diagnosis of the hyperplastic diathesis is generally 
easy, when we remember that the fluids of the body, the 
stomach, and tissues are habitually acid. And if there are 
any abrasions of the skin, they heal promptly by first inten- 
tion, pimples also dry up soon, and form hard elevations 
which usually scale off without the least particle of pus being 
discovered. 

The diagnosis of the diatheses are highly interesting both 
to the physician and surgeon. For by diagnosticating these' 
states prior to the development of diseases, the physician may 
be able to ward off a dangerous affection, by changing either 
the aplastic or the hyperplastic to the normal condition. 
The surgeon may often save life, by being able to distinguish 
the presence of the aplastic diathesis in advance of an im- 
portant operation. Indeed, the most simple operation may 
prove fatal in certain stages of this diathesis. If I were 
asked by the young practitioner of medicine, what would be 
the most important thing to do to become an adept in clini- 
cal medicine, and a successful surgeon, I should unhesita- 
tingly answer — study the diatheses, their diagnosis, and their 
treatment. 



TREATMENT. 

The plastic diathesis being the standard of health, our 
treatment must be directed to the aplastic and the hyperplas- 
tic, so as to bring the patient into the normal condition. 

Aplastic Diathesis. — In the treatment of this diathesis 
the first indications are cleanliness, pure air, light, and a 
proper regulation of the diet. The number of ablutions will 
depend upon the nature of the disease or the wound that 
complicates the diathesis. If the patient be feverish, and the 
skin be hot and dry, there is nothing more beneficial, and 
grateful to the patient, than frequent sponging with cold or 



40 THEORY AND PRACTICE OF MEDICINE. 

tepid water containing chorate of potash. By this simple 
process we diminish the temperature of the body, allay 
febrile excitement, and thereby often arrest any tendency to 
inflammation. We also prevent reabsorption of cutaneous 
emanations, and the skin being thoroughly cleansed, and 
disinfected by the chlorate, the pores are kept open, so that 
there may be a free and unobstructed elimination of effete 
material from the system. It matters not what complication 
may exist, the linen of the patient's person, and bedding, 
should be changed once a day or oftener, if there are any cir- 
cumstances that demand it. All excrements or clothes con- 
taining pus, or other matters, must be removed from the 
room, and disinfectants sprinkled within and about the sick 
chamber. The patient should sleep if possible in an upper 
room, and the windows and doors should be thrown open 
night and day if the weather is warm. But if it should be 
damp or cold the chamber must be thoroughly ventilated, the 
patient screened from the direct draught, and have a little fire 
kindled in his room. There is much more benefit to be de- 
rived from these simple directions than many practitioners 
seem to understand, if we may judge from their practice. 
Indeed, the observing physician is becoming more convinced 
every day that without these precautions medication will often 
prove a lamentable failure. 

The utility of free ventilation may be demonstrated by 
any person upon himself. If we sleep for one night only, in 
a small close room, we awake in the morning feeling languid, 
our lips look purple, owing to a continuous inhalation of the 
exhaled carbon, and there is an indescribable feeling about 
the head. If while in this condition the windows and doors 
are thrown open, and the pure morning atmosphere comes 
rushing in to supplant the foul air which had been breathed 
over and over again, we feel new life and vigor come upon us, 
and soon the purple color of the lips gives place to a Vermil- 
lion tint, owing to the decarbonizing of the blood by the 
oxygen of the fresh air ; the headache disappears, and we 



THEORY AND PRACTICE OF MEDICINE. 41 

feel revived. If bad ventilation has such a depressing effect 
upon those in health, how deleterious it must be to those 
who are already in the aplastic diathesis. Light is almost as 
essential to health as fresh air. But how often have we been 
called in consultation, and had to grope our way in the dark 
and gloomy apartments of the sick, while the outer w T orld was 
tinged and cheered by the mellow rays of an autumn sun. 
Until the profession comes to appreciate more fully the 
utility of light upon the physical and moral systems, and so 
instruct the people as to its healthful influence, we shall con- 
tinue to meet so many persons with that sickly and pallid 
countenance which is so characteristic of those who live 
within doors and exclude both air and light. I know of no 
condition of system in which it is ever advisable to exclude 
light, except in some of the diseases of the eye and brain. 

Diet is an important element in the treatment of the 
aplastic diathesis. The voice of nature should be heeded and 
her cravings satisfied. Patients in this condition will crave 
acids, or those agents that are capable of overcoming the 
akaline condition of system. The diet of a patient, as a rule, 
should not be regulated according to the disease, but in 
accordance with the diathesis. Fresh meat is not only nutri- 
tious in the aplastic diathesis, but it increases the acids of the 
system, and thereby neutralizes the alkalies of the fluids, 
and assists in overcoming the aplasticity of the blood. Milk, 
soft boiled eggs, beef-extracts, and malted milk are highly 
beneficial in this diathesis. 

So long as the aplastic patient is not the subject of inju- 
ries or disease, his condition may be changed by the hygienic 
regulations above mentioned. 

The aplastic diathesis, the bacillus or zymotic poisons, and 
the erysipelatous virus, being the three elements which, when 
combined, are the dread both of the physician and surgeon, 
and often defeat their best efforts and intentions, it becomes a 
subject of no little importance to understand the most ready 
means by which to overcome their influence. All of the min- 



42 THEORY AND PRACTICE OF MEDICINE. 

eral acids are antidotes against the alkalies and the aplastic 
diathesis. You must ever keep in mind the distinction be- 
tween antidotes and therapeutic agents. All schools of medi- 
cine use the same antidotes to poisons. It is at the thresh- 
hold of therapeutics where they separate. 

If you have a patient upon whom you wish to perform 
some important operation, and he is strongly aplastic, then by 
regulating his diet as already recommended, and letting him 
drink freely of acidulated water for a few days you will anti- 
dote the alkaline diathesis and thus prepare your patient for 
a successful operation. Of the mineral acids I have found the 
hydrochloric acid, in the form of the tincture of the perchlo- 
ride of iron the most efficacious in antidoting the alkaline 
diathesis. A goblet of sweetened water containing a few 
drops of the tincture, makes a pleasant drink, which may be 
taken several times a day. The perchloride of iron contains 
three equivalents of chlorine and two of iron. When taken 
into the system of an aplastic patient, it is decomposed, and 
its chlorine is set free, and it readily unites with the alkaline 
bases of the fluids to form chlorides. In this way the alkaline 
condition of the aplastic diathesis is antidoted, the system is 
disinfected, and prepared to respond to the chalybeate and 
tonic action of the iron, by which the plasticity of the blood 
is restored. This method is called antidoting or neutralizing 
the alkaline diathesis. 

In view of this fact the question arises have we, as homoeo- 
paths, any therapeutic agents capable of changing the aplastic 
diathesis without resorting to chemical antidotes ? I answer 
emphatically yes. Arsenicum, calendula, /zefiar sulphur is, 
lachesis, phosphorus, silicia, and sulphur, are capable, in long 
continued or over-doses, of producing in the human system a 
condition similar to that of the aplastic diathesis. This fact 
having been demonstrated, the important question arises how 
do they act upon an alkaline diathesis to bring it into the 
plastic or normal condition ? In crude doses they so change 
the physiological functions of the organs and tissues as to 



THEORY AND PRACTICE OF MEDICINE. 43 

retard the elimination of effete material which being retained 
in the body undergoes a chemical change by which a super- 
abundance of alkalies are retained. And hence a condition of 
system supervenes which resembles that of the aplastic dia- 
thesis. Not that they have any chemical power of increasing 
the alkalinity of the fluids of the body ; but they so act upon 
the secretory and excretory functions as to cause an abnormal 
amount of alkalies to accumulate in the system. 

As it is a well known fact that poor ventilation, unwhole- 
some diet and atmospheric changes, do produce a similar con- 
dition, then when we find an aplastic condition brought about 
by natural causes, if we give one of the medicinal agents I 
have mentioned, in such homoeopathic potencies as to set up 
a dynamic action in the system, then we bring on a conflict 
between the physiological functions of the tissues, the mor- 
bific agent, and the dynamic drug force. Thus while the 
secretory and excretory functions are fighting to gain the 
victory over the morbific agent, the dynamic force of the drug 
steps in and decides the contest. That is to say, the organic 
functions are ever on the alert to prevent any effete material 
from entering the system or remaining in the tissues. Hence, 
when those functions become enfeebled, and are about to be 
overpowered by the morbific agent, then it is that the dynamic 
force of a drug arouses the physiological action of the organs 
and tissues, enables them to overcome the cause and thus 
restore the system to its normal condition. 

Thus you will observe the dual action of drugs. In the 
crude state they produce on healthy organisms certain 
changes which have been called physiological. They also 
act therapeutically by their dynamic force. In other words, 
crude drugs depress organic functions, while if the same drug- 
be potentized, its dynamic force becomes an organic stimu- 
lant. That is to say, the fight, primarily, is between the 
dynamic drug force and the morbific agent, and during that 
contest the organic functions are stimulated to action ; and, 
secondarily, they become the repelling force and are able to 



44 THEORY AND PRACTICE OF MEDICINE. 

expel both the morbific agent and the dynamic drug force 
from the system as foreign invaders, and thus the equilibrium 
of the organic functions is restored. 

Hyperplastic Diathesis. — If the condition of system, 
which this diathesis represents, be acid, we must readily infer 
that the alkalies are the antidote to that condition. The 
diet in this condition must be strictly vegetable. Animal 
food, and everything that is calculated to increase the acid 
condition of the fluids and tissues are contra-indicated. All 
vegetables and vegetable acids increase the alkalinity of the 
fluids and tissues ; for during the process of digestion the 
acid properties of these agents are consumed, and the potash 
and soda, which they contain, enter the circulation, and thus 
neutralize the acids of the system. It is upon this principle 
that lemon-juice often acts so beneficially in rheumatism. 
Soda baths are also beneficial. The alkalies are antidotes to 
the hyperplastic diathesis. But in this diathesis we have 
homoeopathic agents that are capable of restoring the system 
to the plastic diathesis without resorting to alkaline anti- 
dotes. I mention calcaria carbonicum, lycopodizim, phos- 
phorus, robinta, and sulphuric acid, as some of the most 
important remedies. You must remember that these drugs 
produce acidity of the stomach when given in their crude 
condition. I remark, however, that robinia, or the false 
locust, is one of our best agents where the stomach is so sour 
as to set the teeth on edge after belching. 

It may seem paradoxical when I tell you that sulphuric 
acid is an antidote to the aplastic or alkaline diathesis, and 
yet we recommend it as one of our most potent agents in the 
hyperplastic or acid diathesis. Nevertheless it is a scientific 
fact ; for if you give medicinal doses of sulphuric acid to an 
alkaline patient, you change his condition to the normal or 
plastic diathesis ; and by a continuation of the agent you at 
last produce the hyperplastic diathesis. On the other hand, 
if you give potenized doses of the same drug to a patient who 
has not taken any acids, you convert a hyperplastic or acid 



THEORY AND PRACTICE OF MEDICINE. 45 

diathesis into the plastic. We know this to be a fact, and we 
explain it upon homoeopathic principles. That is to say, if 
the physiological action of sulphuric acid on the system is to 
develop an acid condition of the tissues, then the same drug, 
potentized, will by its dynamic force upon the organic func- 
tions, change the hyperplastic or acid diathesis into the plastic. 
In other words, its physiological action is to change the tissues 
to the acid condition by chemical action, while its potentized 
dynamic force so acts upon the organic functions as to cause 
an elimination of surplus acids, and thus bring the system 
into the plastic state. In this way we run no risk in chang- 
ing the hyperplastic or acid diathesis into the aplastic or 
alkaline diathesis, which may be done by giving crude alka- 
lies to antidote the acid condition of the system. 

Having examined a few of the conditions of system by 
which diseases are modified, we come next to notice some of 
their causes. 

CAUSES. 

Etiology or the cause of disease has ever engaged the at- 
tention of the profession, and the subject has been well 
elucidated. But there seems to be some confusion in regard 
to their classification. It seems to me that they can be better 
understood by classifying them under two grand divisions — 
■predisposing a?id exciting. 

PREDISPOSING CAUSES. 

By predisposing causes we understand a predisposition of 
the system to morbid impressions. The aplastic, hyperplas- 
tic, and tubercular diatheses, are predispositions to patholog- 
ical changes, and the cause of that predisposition is the 
predisposing cause of disease. As the alkalinity of the aplas- 
tic diathesis is the predisposing cause of asthenic grades of 
inflammation and malignant disease, so is the acidity of the 
plastic and hyperplastic diatheses the predisposing cause of 



46 



THEORY AND PRACTICE OF MEDICINE. 



sthenic grades of inflammation and of hypertrophy. Now it 
is evident to every observer, that patients do often remain 
long in either of those diatheses without contracting disease ; 
but so soon as a specific, or an exciting cause, is brought to 
bear upon those conditions, the patient is prostrated by some 
affection. If his diathesis be scrofulous, rheumatic, or gouty, 
then those conditions are the predisposing cause of scrofula, 
rheumatism, and gout ; yet he may never have either unless 
he is brought under the influence of the exciting cause. 



EXCITING CAUSES. 

The exciting causes of disease are very numerous, and it 
will be unnecessary to mention all of them at this time, as we 
shall direct attention to many of them under the discussion 
of each disease. For convenience of description, the exciting 
causes of disease may be divided into general, specific, and 
toxicohsemic ; and they may be seen in the following table : 

Mechanical, 
Electrical Changes, 
Vicissitudes of Climate, 
Cold, 

General -{ Heat, 

Light, 

Atmospheric Impurities, 
Unwholesome Diet, 
Moisture, &c. 



Exciting Causes. 



Specific 



Certain Poisons, 
Contagious Virus, 
Miasmata. 



{ 



Toxocological X Toxicohaemia 



General causes of disease are those which act generally 
irrespective of the diatheses. By specific cause we under- 
stand that agent which is capable of generating a particular 
disease ; that is to say, the virus of small pox, or any other 
contagious distemper, can only produce one disease, and that 



THEORY AND PRACTICE OF MEDICINE. 47 

always of the same generic character. I now refer to pri- 
mary diseases, for it is a well known fact that specific dis- 
eases are capable of exciting- into action a chronic disease 
which has long lain dormant in the system, or they permit 
secondary affections, called sequela, to follow in their train. 

By toxicohsemia, we understand blood-poisoning. All 
causes, which change the elementary properties of the blood, 
and render it deleterious to the tissues, and unfit to supply the 
organs with nutriment, are termed toxicohaemic. It is an in- 
teresting field, for study, to inquire into the modus operandi 
of those causes upon the system so as to produce the various 
modified forms of disease. 

To illustrate the difference between general and specific 
causes, I point first to the effects of cold. It produces no par- 
ticular disease, but simply excites to action the peculiar 
diathesis under which the patient is laboring at the time of 
his exposure. If a patient is in the lithic acid, or rheumatic, 
diathesis, and if the skin and kidneys are making a vigorous 
effort to throw off the effete material at the time that he is 
exposed to a sudden change of temperature, the excretions are 
checked, the poison is reabsorbed, and produces an irritation 
or inflammation of the tissues surrounding the joints, which 
is called rheumatism. But, on the other hand, if suscepti- 
bility be increased, general plethory of the capillary system 
be present, reflex action vigorous, and if the patient be in the 
plastic or hyperplastic diathesis, then a certain amount of ex- 
posure to cold will produce internal congestions, and inflam- 
mations, especially of the mucous membranes and of the 
lungs. The grade that the inflammatory process will assume, 
will be in accordance with the plasticity or aplasticity of the 
patient. And the nomenclature is given in accordance with 
the part affected. The specific causes act independently of 
cold or any other agencies than their own zymotic properties, 
and they are only controlled or modified in their progress and 
severity by the diatheses. 

The exciting causes might be more appropriately divided 



48 THEORY AND PRACTICE OF MEDICINE. 

into general and zymotic. Zymotic is a Greek word and 
means a ferment. It is now applied to those diseases which 
are supposed to be produced in the system by a fermentive 
process set up by microbific agents called bacilli. It may be 
interesting to inquire into the nature of a ferment, and see if 
there is any analogy between the action of the leaven of 
organic matter, and the leaven of animal effluvia and conta- 
gion. It has been shown that if certain organic substances of 
the vegetable and animal kingdoms be brought in contact 
with certain other elements, and a certain amount of heat and 
moisture be present, that a chemical change takes place, called 
catalysis or a catalytic transformation. This change does not 
affect the organic substances ; simple contact is sufficient to 
change the elements with which they are mingled. But if 
from any cause the organic matter begins to decay then it in- 
duces in certain other substances a change called fermenta- 
tion. If the mucus of the bladder, which contains an organic 
substance, is exposed to the atmosphere, it attracts therefrom 
certain elements which cause decomposition, and as the de- 
caying organic matter comes in contact with urea of the urine, 
fermentation takes place, and it is converted into carbonate 
of ammonia. The same thing has been known to take place 
when the urine was retained in the bladder until decomposi- 
tion had taken place. In the same manner does the organic 
matter of grape juice act upon the sugar, and gives rise to fer- 
mentation by which alcohol and carbonic acid are produced. 
It has also been proved that the organic substances are the 
only ones capable of undergoing putrefaction. This change 
has been known to take place within the body, and pus glob- 
ules have been detected in the blood. These facts furnish a 
key to the action of zymotic agents on the system by which 
disease is produced. 

It is believed that as soon as a minute portion of the poi- 
son of a contagious disease, or of miasmata, is introduced into 
the system, and comes in contact with the organic elements of 
the tissues, that a putrefactive process takes place by which 



THEORY AND PRACTICE OF MEDICINE. 49 

fermentation is set np and a blood poison is generated, from 
which the system is inoculated, and a disease is developed 
whose symptoms, course, and termination are in keeping with 
the general characteristics of the specific agent. 

If the theory of diatheses and zymoses be true, then our 
duty at the bedside will be plain, and we will have no diffi- 
culty in selecting the remedies for each. 

I wish to remind you of the fact that, in the past, the med- 
ical profession has, unfortunately, run nearly every thing to 
extremes. They are now obscuring the cause of disease by 
laying so much stress on bacteriology. As you are now be- 
ginning the study of bacteriology be careful that the enchant- 
ing field may not bewilder you and lead you to extremes as to 
the cause of disease. If you have a patient who yesterday was 
in robust health, and in the hyperplastic diathesis, and who 
was caught in a snow storm in the afternoon, and to-day is 
prostrated with rheumatism, would not common sense tell you 
that the hyperplastic or acid diathesis was the predisposing, 
and the snow storm the exciting cause of rheumatism. You 
do not need the microscope, or a knowledge of bacteriology to 
tell you the cause of rheumatism ; chemistry comes to your 
aid in this case. 

When you come to study zymotic or specific diseases then 
your microscope and knowledge of bacteriology comes to your 
relief. Even in those cases you must make an intelligent ex- 
amination to arrive at a correct conclusion. If you find bac- 
teria, you do not know whether they are the cause or the pro- 
duct of the disease. I presume that there is no doubt that the 
morbific agent of zymotic diseases is an animalcule called ba- 
cillus, which sets up a fermentative process that develops the 
disease which results in a culture of bacteria. Life and human 
organisms are a grand mystery. It would seem that all or- 
ganized bodies are composed of living animalcules called bio- 
plasts, and hence the distinction between them and bacteria 
must be made. 



DIAGNOSIS 



Diagnosis is the distinction of disease ; or it is an inquiry 
into the symptoms and character of disease ; so as to enable 
us to weigh and compare the different pathological condi- 
tions, and determine to which class of diseases certain 
symptoms belong. 

You should make yourselves familiar with the general 
characteristics that belong to all disease ; and then study 
carefully in detail the special or differential symptoms be- 
longing to each particular malady. You should always make 
it a point to examine your patients carefully, whether the 
symptoms indicate a grave or a mild character of disease 
or not ; for by so doing you are often enabled to detect the 
incipiency of a dangerous complication, which you are able 
to arrest, but which if neglected until your next visit may 
have made such rapid progress as to be beyond the reach of 
remedial agents. You should examine all the organs, secre- 
tions and excretions, within your reach, and ascertain the 
condition of the bowels, urinary organs, tongue, and pulse ; 
and get a correct history of the case as to its mode of inva- 
sion, duration, and severity of its symptoms 

Pulse. — The pulse is an important element both in diag- 
nosis and prognosis. A frequent, full and soft pulse, is an 
indication of an acute febrile disease, especially of the erup- 
tive fevers and pneumonia. If in addition to the foregoing 
characteristics the pulse imparts to the finger a vibratory or 
wiry feel, it is diagnostic of erysipelas. If you study with 
care the pulse of an erysipelatous patient, and practice the 
finger to its peculiar beat, you may tell the character of the 



THEORY AND PRACTICE OF MEDICINE. 5 1 

disease before the swelling and redness, which are character- 
istic of erysipelas, make their appearance. A frequent, quick 
and small pulse, is characteristic of phthisis and anemia. A 
pulse rather frequent, full, and soft, indicates plethory and 
overloading of the heart with blood. A frequent, large, hard, 
and quick pulse, indicates inflammation, or an inflammatory 
fever. A slow, languid pulse indicates prostration. And, 
finally, if at the close of any disease, with the above condi- 
tion of the circulation, you should find the pulse becoming 
quick, feeble, and fluttering, then the prognosis is unfavora- 
ble and you may look for a speedy dissolution of your patient. 

It requires a good deal of care and practice to understand 
the pulse correctly. It is difficult to impart a knowledge of 
the pulse by written instructions. It is only at the bedside, 
that you can gain the necessary qualifications for it. 

A very ingenious instrument, called the sphygmograph, 
has been invented by Marey, by which the pulse wave may 
be delineated on paper, also its frequency and the cardiac im- 
pulse may be detected. But even this requires a great deal 
of care to arrive at correct conclusions ; for it is sometimes 
impossible to use the instrument on children and nervous 
patients ; so you see, with all the aids at your command, you 
must rely on your own judgment and sense of touch to ob- 
tain a satisfactory result. 

Thermometer. — The thermometer is an important aid 
in diagnosis, by which we gain a correct knowledge of the 
temperature of the body. There are two modes of using it ; 
the bulb is either placed under the tongue, or axilla. The 
latter is probably the preferable site. In the healthy subject > 
the average temperature of the body is 98. 5 ° an allowance of 
1 ° being given for difference of latitude ; so then if the tem- 
perature rises above 99. 5 ° or, falls below 97. 5 °, we infer that 
a morbid action is going on in the animal economy ; except 
in the very old, it may fall to 97 ° and still he be healthy. 
Different diseases produce different degrees of temperature. 
In typhoid fever it is from 101 to 103 . If it rises to 105 



52 THEORY AND PRACTICE OF MEDICINE. 

the disease is of a grave character ; and if it still goes up to 
106 the patient is in great danger, and generally dies. If it 
rises to 104 in pneumonia and rheumatism the symptoms 
become alarming. In scarlet fever, the temperature may rise 
to 105 or 106 when the disease is at its height ; but when 
it goes above 106 , we look upon the patient with solicitude. 

The thermometer may aid us materially in prognosis, as 
well as in diagnosis. Thus, the increased frequency of the 
pulse may be due to fever or debility ; if to the former, the 
temperature will be increased, but if to the latter it will be 
diminished ; so if the pulse is quick and weak from exhaus- 
tion, then your prognosis must be very serious. Then again, 
a patient may be found in a profuse perspiration ; and it 
may be either caused by a previous febrile excitement, or the 
source of exhaustion. If from the former, the thermometer 
shows an increased temperature ; but if from the latter, it is 
diminished and the prognosis is very grave. 

It is believed that when a gradual deposit of tubercular 
matter is going on in the lungs, a rise of temperature of the 
body may be observed by the thermometer. If this be so 
then the thermometer becomes a means of diagnosis in the 
incipient stages of phthisis. 

Tongue. — The tongue is a good index to morbid action, 
and therefore diagnostic. A dry tongue is an indication of 
febrile action in which the secretory functions are arrested. 
If it is dry and brown in the center, it is diagnostic of inflam- 
mation of some portion of the alimentary canal. In typhoid 
fever, the tongue is covered with a thin, dirty white coat. 
Miasmatic diseases give it a thick coat inclined to a yellow 
cast. In scarlet fever the tongue is red and shining, with the 
papilla elevated and resembling a strawberry. When the 
blood is deficient in red corpuscles the tongue indicates it by 
its pale color. The unfavorable prognostic signs as derived 
from the tongue, are a dryness of a livid color, red, shining 
and raw and a heavy coating of a dark hue. The favorable 
signs are a returning moisture and clearing from the tip and 



THEORY AND PRACTICE OF MEDICINE. 53 

edges. If it cleans from the center, convalescence is pres- 
sure but slow. If the shining begins to coat, it is favorable, 
and when the pale tongue begins to change to a red, it is an 
evidence that the blood is returning to its normal condition. 

The excrementitious matter is a means of diagnosis. By 
an examination of the stools we are able to detect an increase 
or deficiency of bile ; and we are able to determine the loca- 
tion and character of an intestinal lesion by the feces. Thus 
if the stools are thin and watery, we infer that the small in- 
testines are the seat of trouble ; but if they are frequent and 
contain mucus and blood, then we know that the colon is in- 
volved. By an analysis of the urine we are able to detect the 
presence and character of many pathological conditions, which 
would otherwise remain obscure. 

The character of the ejections from the stomach often 
enables us to determine the nature of the disease. I will refer 
to these subjects again when I come to the symptoms of disease. 
The other important aids that will greatly assist you in 
your diagnosis, are inspection, measurement, pressure, palpa- 
tion, succussion, percussion, and auscultation. 

Inspection. — By inspection the color of the skin, ex- 
pression of the eye, flush of the cheek, movements of the pa- 
tient, distortion and pallor of the features, and hypertrophy 
and atrophy of the muscles, are all detected. 

Measurement. — By measurement, you ascertain wheth- 
er one limb is longer or shorter, larger or smaller, than the 
other; and by it you detect the inequalities and expansion of 
the chest. By placing a tape line around the patient above the 
nipples, and causing him to contract the chest, by throwing 
the air from the lungs, you measure and note the size on the 
tape ; he is then directed to inflate the lungs to their utmost 
capacity; the difference between those two states shows the 
expansibility of the chest. In examinations for life insurance, 
if the applicant can not expand two inches, he is rejected, be- 
cause there must be some disease or contraction of the chest 
if he cannot expand two inches or more. 



54 THEORY AND PRACTICE OF MEDICINE. 

Pressure. — By pressure you are able to detect tender- 
ness or inflammation of the internal organs. Pressure is made 
with the open hand or ends of the fingers. If a slight pres- 
sure upon the abdominal cavity creates pain, it is diagnostic 
of irritation or inflammation of the muscles of the abdomen ; 
but if it requires pretty hard pressure to create pain, then you 
may know that the internal organs are involved. If the pain 
is very acute, and accompanied with fever, the inflammation 
is in the peritoneum. I wish to impress upon you this diag- 
nostic sign, for you will often question patients with regard 
to pain or suffering, and they will tell you they have none, 
when upon a close examination by pressure you often detect a 
great degree of lesion. To illustrate this point and to show the 
importance of a correct diagnosis, I take the liberty to relate 
a case that came under my observation. A gentleman called 
on me, stating that he had been afflicted for three months with 
a cough, slight fever and a general prostration of the nervous 
system ; he had been treated for bronchitis, by two physi- 
cians, without any relief. Upon a careful examination I found 
the right kidney to be highly sensitive and hypertrophied. 
By the appropriate remedies for that pathological condition, 
the irritation was relieved and the kidney reduced to its nor- 
mal size and function ; the cough disappeared and the patient 
was restored to health. Thus you see the importance, both of 
the application of pressure and of a correct diagnosis, as to 
whether some of the symptoms may not be of a reflex character. 

Palpation. — Palpation or the touch is used to ascertain 
the amount of heat, dryness, moisture, and other qualities of 
the skin. By it we examine the normal and abnormal quali- 
ties of the pulse, and detect fluids in the cellular and muscu- 
lar tissues. If you press upon a swollen limb, and it feels 
doughy and indentations of your fingers are left, then you may 
be sure that dropsical effusion has taken place beneath the in- 
teguments. You can detect thrills and vibrations ; and by 
this means diagnosticate the character of tumors. If you 
place your hand flat upon one side of a tumor and strike it 



THEORY AND PRACTICE OF MEDICINE. 55 

lightly with the other, if it contains pus or fluid you can detect 
it by the vibration communicated to the hand that is in con- 
tact with the tumor. 

SliCCUSSion. — Is the act of giving the chest or abdomen 
a sudden jerk, by which a shaking motion is communicated to 
the contents of the cavities, so that if air and water be present 
a splashing sound is produced, which reveals the pathological 
condition of the parts. It may be produced by placing the 
hands upon either side of the abdomen or chest, and move 
them quickly from side to side. 

Percussion. — Is the act of striking those parts which in- 
vest cavities for the purpose of eliciting sounds by which we 
may judge of the physiological and pathological condition of 
the viscera contained within. By practicing percussion on 
the healthy subject the ear is educated to the normal sound, 
so that when an abnormal sound is produced, it may be readily 
detected. There are two methods by which percussion may 
be practiced — immediate and mediate. The former mode is 
practiced by striking the surface of the body with the ends of 
the fingers ; the latter by placing some firm substance upon 
the parts to be struck. The instrument used in practicing 
mediate percussion is a flat piece of ivory an inch or an inch 
and a half in diameter, or what is still better, a piece of hard, 
rubber of the same dimensions. This little instrument is 
called a pleximeter, and with it is used a small hammer made 
of wood, ivory, or metal, and the ends are covered with felt or 
caoutchouc, so as to modify or destroy the sharp click or 
metallic sound, which is produced by bringing two hard sub- 
stances in contact by force. But I think, as a general rule, 
that the best pleximeter is one or two fingers of the left hand, 
and the points of the three first fingers of the right to be used 
as the hammer. It requires a good deal of care to practice 
percussion correctly and with profit. The patient should be 
seated in the upright position, with the shoulders thrown back, 
and the chest may be covered with a thin and closely fitting 
fabric. If you use the finger as a pleximeter, it should fit 



56 • THEORY AND PRACTICE OF MEDICINE. 

tightly against the parts so as to render the muscles tense ; 
you then place the ends of the three first fingers of the right 
hand on a line with each other, and bring them down perpen- 
dicular on the pleximeter with a quick blow, the force being 
regulated by the wrist. In order to compare the sounds elic- 
ited on both sides of the chest the corresponding positions 
must be used alternately. After examining the anterior part 
of the chest, and noting the difference in the sounds, if any, 
the patient is made to lean forward, and the posterior parts 
are examined and compared in the same manner as the 
anterior. When you percuss the sides and axillary spaces, the 
arms should be elevated above the head. The sound elicited 
by percussing over a healthy lung, is a hollow sound, resemb- 
ling somewhat the one produced by striking the head of a 
barrel half filled with water. If the chest was empty, or con- 
tained nothing but air, then the sound would be clear, but 
containing as it does a spongy substance filled with air, we 
elicit a sound neither dull nor clear but one better understood, 
when once heard, than can be explained. The sound pro- 
duced by percussing over all parts of a healthy lung approxi- 
mates so nearly a clear sound in contradistinction to that of 
a dull one, that we adopt the expression of a clearness or 
dullness on percussion. You can appreciate the difference by 
first percussing your chest and then the muscles of your thigh. 
Having fixed these points in the mind, and having once heard 
the clear sound produced by percussing the healthy chest, we 
are able to measure the departure therefrom, and the increase 
of dullness in pathological conditions. As we shall call your 
attention to this subject again when we come to speak of the 
diseases of the chest, we will then point out the modification 
of sounds, and the morbid condition that gives rise to them. 

We now direct your attention to an important aid in di- 
agnosing diseases of the chest ; one that is always practiced 
in connection with percussion, and without which you can 
know but little of the various stages and progress of the dis- 
eases of that region. I refer to 



THEORY AND PRACTICE OF MEDICINE. 57 

Auscultation. — Auscultation is the act of applying the 
ear to the chest in order to listen to the physiological and 
pathological sounds produced within. Like percussion it is 
both immediate and mediate. The former is practiced by 
applying the ear directly to the chest ; the latter by the use of 
an instrument called the stethoscope. They are of two varie- 
ties — single and double. The single one I only mention to 
condemn ; for it is uncertain, inconvenient to use, and far in- 
ferior to the naked ear. The double instrument is a valuable 
companion at the bedside, and under certain circumstances it is 
almost indispensable. In the use of this instrument a great 
deal of care is requisite ; for if it be pressed too tightly it will 
cause pain to the tender parts ; if it is not held level, and 
with some degree of firmness, you will get an uncertain sound. 
And then again, if you permit any movement of the instru- 
ment against the clothing or muscles a friction sound is 
produced, and conveyed to the ear through the tubes and 
obscures the sounds in the chest. Before proceeding to aus- 
culate, the room should be made comfortably warm and free 
from noise ; the chest should be bare or covered with a thin 
covering and free from friction ; each part should be examin- 
ed and the sounds compared as recommended in percussion. 
You should practice on the healthy subject, so as to become 
familiar with the normal sounds of the chest, and then you 
will be able to detect any departure therefrom. The sounds 
heard in ausculating the chest may be divided into three pri- 
mary divisions, to-wit : natural respiratory murmur, vesicular 
rale, and bronchial rale. They may be seen to a better ad- 
vantage in a tabular form, thus : 



I 



Natural Respiratory Murmur, 
Primary Sounds. -J Vesicular Rale, and 
Bronchial Rale. 



The first is the natural or physiological division of sounds 
heard in the healthy lung. The second and third are abnor- 
mal sounds, and show a morbid condition of the parts within 



5« 



THEORY AND PRACTICE OF. MEDICINE. 



the chest. Each of those divisions may be again subdivided, 
showing the different sounds in health, and the degrees or 
stages of morbid action. 



Natural Respiratory Murmur. 



Normal. 
Vesicular. 



Bronchial. 
Tracheal. 



Abnormal. 
r Exaggerated, 
Prolonged, 
Diminished, 
Irregular and 
Remittent. 

Tubular. 



Thus the natural respiratory murmur is divided into the 
vesicular, bronchial, and tracheal. The first departure from 
this normal condition, may be expressed in six degrees or 
conditions to-wit : the vesicular murmur may be exaggerated, 
prolonged, diminished, irregular, and remittent ; and the bron- 
chial and tracheal may be tubular. The natural respiratory 
murmur is the sound produced by the ingress and egress of 
air through the trachea, .bronchi, and lobules of the lungs. 
The sound, heard over the different parts of the lungs, is call- 
ed vesicular, because it is produced by the rushing of air into 
the pulmonary cells or vesicles. It denotes that the lobules 
are permeable to air, and are therefore in a healthy condition. 
The vesicular murmur has been compared to the sighing of a 
gentle breeze. The bronchial and tracheal respiratory mur- 
mur is produced by the passage of air through the larynx, 
trachea, and bronchi. It resembles the rushing of dry air 
through a large empty space. The vesicular murmur may be 
exaggerated or increased by an exaltation of the respiratory 
movement, or whatever increases the rush of air into the 
pulmonary cells ; thus, if a part of the lung be congested, the 
other portion must perform a double office ; consequently, 
the respiration will be more rapid, and the sound louder, in 
the healthy lung ; thus demonstrating the fact, that a patho- 
logical change has taken place in some part of the chest. The 



THEORY AND PRACTICE OF MEDICINE. 59 

sound may be prolonged by any cause that retards the egress 
of air from the vesicles. On the other hand, the sound may 
be diminished by any pathological change in the bronchial 
tubes or lobules, by which the air is permitted to enter the 
cells in a diminished quantity and force. Sometimes the 
murmur is irregular, owing either to spasm of the ultimate 
bronchial tubes, or obstructions in the bronchi. Spasmodic 
asthma furnishes a fine illustration of the irregular vesicular 
murmur ; at one breath the air is almost entirely excluded 
from the vesicles, while at the next, by a powerful effort at 
inspiration, the spasm is broken and the air rushes in and out 
of the cavity of the lobules. Sometimes the cause is not suf- 
ficient to produce an interruption or irregularity, but only a 
gradual rise and fall of the impulse ; in this condition the 
murmur is said to be remittent. The bronchial and tracheal 
respiration may be changed by congestion or consolidation of 
the ultimate bronchial tubes ; consequently, the sound must 
come only from the larger tubes, producing a tubular or me- 
tallic sound. 

The importance of having a correct knowledge of the natu- 
ral respiratory murmur, its subdivisions and pathological 
changes, cannot be overestimated ; for it is only by a correct 
knowledge of this division of auscultation that we are able to 
detect the first symptoms, or incipiency of phthisis, at which 
time it is desirable to detect, if ever, its presence ; that being 
the only stage in which much, if any, hope may be enter- 
tained from medical aid. 

We now invite your attention to the second and third divi- 
sions of our subject, or the beginning of that condition of mor- 
bid sounds which we denominate rale. Rale is a French term, 
denoting rhonchus, or a rattling sound. 

I have already stated that the rale was a primary morbid 
sound and was of two varieties ; to-wit, vesicular and bron- 
chial ; these terms denote the location of the sounds. The 
vesicular rale may be subdivided under three headings, and 
may be seen at one view in the following table : 



60 THEORY AND PRACTICE OF MEDICINE. 



■{ 



Crepitant, 
Vesicular Rale. ■{ Sub-Crepitant, 
Crackling. 



The crepitant rale is a creaking noise, heard in the congestive 
stage of pneumonia. When the cavities of the ultimate bron- 
chial tubes are diminished in size by congestion of their tis- 
sues, the air forces its way into the agglutinated air-cells, and 
causes their walls to separate and press against their neighbor 
at each act of inspiration, and thereby produce the crepitation. 
It may be compared to the sound produced by throwing salt 
on a hot surface ; also to that produced by rubbing a lock of 
hair between the thumb aud finger near the ear. The sub- 
crepitant rale is a coarser sound than the crepitant. It is 
heard under similar circumstances and differs only in this, 
that the congestion has progressed so far as to produce an exu- 
dation of lymph into the lobules and air-cells, which gives a 
bubbling sound that nearly obscures the fine crepitations of 
the former. The crackling rale is so much like the crepitant 
that it is very difficult to distinguish the two. The sounds of 
the former are finer and more diffused. It is an indication of 
tubercular deposit, and is generally heard in the apex of the 
lung, while the latter is heard in the base of that organ, and 
is supposed to be diagnostic of pneumonia. The third divi- 
sion of auscultation, or the second degree of morbid sounds, 
we have denominated bronchial rale ; because they are heard 
in the bronchi. There are two rales produced by morbid con- 
ditions of the bronchial mucus membrane, called the dry and 
the moist. These again may be subdivided into the sonor- 
ous, sibilant, mucous, and sub-mucous ; and are thus grouped. 

Sonorous, 
Sibilant. 
Bronchial Rale. 

Mucous, 
Sub-Mucous. 

The sonorous rale, or rhonchus, as it is sometimes called, 
is heard along the track of the larger bronchial tubes. It de- 




THEORY AND PRACTICE OF MEDICINE. 6 1 

rives its name from the Greek word rhonchces, which means 
snoring. It therefore resembles the sound produced when a 
person is sleeping. It has also been likened unto the cooing 
of a pigeon. The sound is no doubt caused by the dryness of 
the mucous membrane of the bronchi, and is a diagnostic 
symptom of dry bronchitis. The sibilant rale comes from 
sibilo, I hiss, I whistle ; therefore it is a hissing or whistling 
sound ; and is caused by the rushing of air through the 
smaller bronchial tubes. It may be produced in the larger 
tubes when their calibre is diminished by congestion. Both 
the sonorous and sibilant rales indicate dryness of the mucous 
membrane of the larger and smaller bronchial tubes. The 
mucous rale is heard over the larger bronchial tubes, and it 
is caused by the passage of air through the fluid contained 
within the tubes. As the air becomes entangled in the mu- 
cous secretion, it produces a bubbling sound, which is charac- 
teristic of bronchitis. The same sound may be heard if blood 
or pus is in the tubes ; which is often the case in hemorrhage 
of the lungs ; bursting of tubercular abscess ; or the suppura- 
tive stage of pneumonia. But the history of the case, and the 
general symptoms, will enable you to distinguish the charac- 
ter of the secretion. Then again if the fluid be mucus, the 
rale is louder and coarser owing to the difficulty the air has in 
passing. But if it be pus or blood the sound is not so loud, 
but more wavy. The sub-mucus rale differs from the mucus 
only in degree and location. The sound is chiefly heard in 
the smaller tubes, and from this fact the bursting bubbles are 
less ; consequently the sound must be weaker. There is a 
slight creaking sound produced by the movements of the lungs 
against the pleura ; but if the pleura is dry, a rough sound is 
heard called the friction sound ; and it is diagnostic of pleu- 
risy. There is a vibratory sound heard by the contraction of 
the muscles, which you must not confound with those of the 
chest. 

Voice Sounds. — Which are heard in auscultation, are 
certain impressions communicated to the ear by the transmis- 



62 THEORY AND PRACTICE OF MEDICINE. 

sion of the voice through the trachea and chest. They are 
valuable diagnostic aids, in connection with the other sounds 
to which your attention has already been called. These voice 
sounds are susceptible of division into vocal resonance, and 
abnormal sounds, and these again may be subdivided, as may 
be seen in the following table. 

{Tracheophony, 
Bronchophony, and 
Pectoral Resonance. 

f Bronchophony, 

Second Abnormal Voice Sound. J ^gophony, 

Pectoriloquy, and 
[_ Amphoric Resonance. 

You will observe, by looking at the first division of the table, 
that the normal resonance or voice sounds are three. By 
vocal resonance we understand the normal sounds communi- 
cated from the voice through the walls of the chest to the ear 
of the ausculator. Each division of the chest develops a dif- 
ferent sound, corresponding to the capacity of the parts to 
transmit or absorb sound. Thus, if you place the stethoscope 
over the trachea, and cause the patient to speak, the sound 
passes directly through the tubes to the ear, and you are able 
to distinguish the articulations of the voice. This is called 
tracheophony. If you move the stethoscope to the top of the 
sternum, or over the track of the larger bronchi, the voice is 
still distinctly heard ; but you are scarcely able to distinguish 
the articulations of the voice. This we denominate broncho- 
phony. Then again, if you carry the instrument over different 
portions of the lungs, the voice is not heard, but a vibratory 
sound is communicated to the ear, which may be distinctly 
felt by laying the hand flat upon the chest. This sensation 
is called pectoral resonance or vocal fremetus. Any patholo- 
gical change that may take place in the trachea, bronchi, and 
lungs, alters the tone of these sounds, and they are then term- 
ed morbid or abnormal. They are divided into four classes 



THEORY AND PRACTICE OF MEDICINE. 63 

as may be seen by reference to the second division of the 
table. 

You will probably be a little puzzled, at first, to know 
why I have placed bronchophony both in the normal and 
abnormal division of sounds. It is not because there is any 
change in the sound ; but it simply shows that a morbid 
change has taken place in those parts, and permits the sound 
to be heard ; whereas, in their normal condition it could not 
be heard. Thus for instance, bronchophony is heard in all 
parts of the bronchi, until the tubes are lost in the substance 
of the lungs. The lung substance surrounding the tubes 
being spongy and filled with air, the sounds from the tubes 
are intercepted or absorbed, and do not reach the ear. But if 
the tissues are condensed, they then become a conducting 
medium of sounds from the bronchi, to the ear placed over 
that part of the chest. The sound then is really a bronchial 
sound, as much so as if heard over the larger bronchi, except 
that the difference in the size of the tubes will make a cor- 
responding diminution in the sound. Therefore, when bron- 
chophony is heard over any portion of the chest beyond its 
natural boundaries, it becomes a diagnostic sign, and indi- 
cates a morbid condition of the lung substance. ^Egophony 
is supposed to be produced by the sound of the voice passing 
through a liquid before reaching the ear. The sound is so 
peculiar, that it has been likened to the bleating of a goat. 
If there is a cavity in the lung, and you apply a stethoscope 
over the morbid part, and the patient is made to count one, 
two, three, the sound passes directly through the tubes of the 
instrument to the ear. This sound is called pectoriloquy, 
and it is an evidence that a tubercular abscess has taken place 
and a cavity has been the result thereof. It differs from 
bronchophony in this, that while in the former the sound is 
distinct and the articulations almost perfect, in the latter, 
while the voice sound is clear the articulations are very in- 
distinct. But if that cavity communicates with the bronchi, 
by a small aperture, then the voice enters that chamber, and 



64 THEORY AND PRACTICE OF MEDICINE. 

reverberates from side to side, and does not reach the ear as 
bronchophony and pectoriloquy ; but produces a tingling me- 
tallic sound called amphoric resonance. If a cough is produced 
by any of these morbid changes, it is named in accordance 
with the character of the sound. Thus if bronchophony be 
heard, then the cough is said to be bronchial. If pectorilo- 
quy is the morbid sound the cough is called cavernous. But 
if the cavities have firm walls and narrow outlets then the 
cough is amphoric. 

There are other sounds heard in the chest by auscultation ; 
but as they are confined to the heart in its normal and abnor- 
mal condition, I will reserve my remarks on that subject until 
I come to speak of the diseases of that organ. 

PROGNOSIS. 

This means foreknowledge, and signifies our ability to 
foretell the cause and termination of disease. It is an interest- 
ing study, and one with which we should be familiar ; for it 
is pleasant to yourselves, to the patient, and friends, for you 
to be able to give a correct idea of the final result of each case. 
But let me warn you to be on your guard ; for much of your 
reputation and success hangs on this point. If you should 
give an unfavorable prognosis, and the case should turn out 
favorably, the patient and friends would lose confidence in 
your ability. But, then again, if you should predict a certain 
result, and it comes to pass in the manner and time you stated, 
then you would be looked upon as a very knowing and skill- 
ful physician. Therefore, your prognosis should always be 
guarded. Prognosis is better understood by studying it in 
connection with each disease. There are, however, some 
general prognostic signs that we may examine in this place. 
If, in all forms of disease, the pulse has been frequent or 
irregular, and the tongue covered wiih a heavy fur, or if it is 
preternaturally clean and dry, and they undergo a change, the 
prognosis may be favorable or unfavorable in accordance with 



THEORY AND PRACTICE OF MEDICINE. 65 

that change. Thus, if the pulse becomes more regular and 
less frequent, and the tongue begins to clean, or the clean 
shining tongue begins to mc : sten and fur, then your prog- 
nosis may be favorable. But if the pulse becomes more fre- 
quent and fluttering, the tongue becomes dry, and sordes gather 
around the teeth, the mind wandering, the patient slipping 
down in the bed, and picking at imaginary objects, then your 
prognosis must be most unfavorable. And, finally, if the alse- 
nasi are contracted, and the muscles around the mouth look 
pinched, and the pulse is so quick and feeble that it can not 
be counted, then you may look for a speedy dissolution of your 
patient. If you draw your finger, with some degree of firm- 
ness, across the forehead of your patient, and it leaves a red 
streak, you may know that the circulation is still vigorous in 
the capillary system. But if the print of the finger is left pale 
or unchanged, and no appearance of a return of blood to the 
part, then you may be sure that there is but little vitality left, 
and consequently the patient can only survive but a few hours. 
It is difficult or impossible to prognosticate many diseases 
until after they have passed a certain stage, called the turnings 
point or crisis. The disease at this period may assume a favor- 
able or an unfavorable change, and the symptoms are said to 
be critical. Therefore, you should reserve your opinion until 
after this period in those diseases which are known to be sub- 
ject to this rule. 

DEATH. 

Death, the terror and dread of all mankind, takes place in 
one of three ways — notwithstanding the numberless causes 
and means by which it is produced. That life which ani- 
mates the animal mechanism and controls the vital functions, 
makes its exit either through the brain, lungs, or heart ; that 
is to say, death enters, overpowers it, and compels it to retreat 
through one of those avenues. Therefore, death is only a 
relative term to express a dissolution of the body ; for when 

5 



66 THEORY AND PRACTICE OF MEDICINE. 

the life-giving principle of the human organism takes its 
flight, the body, which is nothing but a tenement of clay, 
crumbles back to mother earth. The world is laboring under 
a great delusion in regard to the death struggle. The agony 
of the dying is often pictured in vivid colors, but the truth is 
that life passes out of the tenement as quietly as the ripening 
fruit falls when fully matured. The agony is produced and 
felt amid the conflict which is waged between health and 
disease, but when life has yielded the struggle and permitted 
disease to gain the ascendancy, death passes in and closes the 
scene without the movement of a muscle or evidence of pain. 
The three modes by which death takes place are : ist, by 
syncope ; 2nd, by apncea ; and 3rd, by coma. Syncope is 
produced by two pathological conditions, and the causes 
thereof are numerous. The three modes and the subdivision 
may be stated as follows : 

First. Death by Syncope < . ., . > Through the heart. 

}__ Asthenia. J 

Second, Death by Apxoea — Through the lungs. 

Third. Death by Coma — Through the brain. 

By a careful examination of this table, and the meaning of 
these terms, you will readily see why it is that death must 
take place by one or the other of these three modes. If syn- 
cope is the result of a morbid action of the heart, or a failure 
of the circulation ; then it is evident that death must take 
place immediately if that organ ceases to act. 

Syncope, as you are aware, means fainting or swooning. 
There are many causes that may produce this effect or condi- 
tion ; but if their force be partially expended or arrested before 
reaching that stage, in which the heart's action is controlled 
and influenced, it soon recovers from the shock, and the pa- 
tient revives. But there are two morbid states of the system 
which so affect the heart's action, that it is unable to rally or 
carry on its function ; and the patient succumbs to the dis- 



THEORY AND PRACTICE OF MEDICINE. 67 

ease or cause which produces those pathological conditions. 
The first of those conditions is anaemia. 

ANEMIA 

Signifies privation of blood. Now all of the organs and tis- 
sues are nourished and stimulated by the blood ; so if from 
any cause the supply be cut short, or deprived of its tonic 
properties, debility and death will be the result. If a person 
be wounded in any of the main arteries, or hemorrhage takes 
place from any cause, he dies because there is not blood 
enough left to stimulate the heart to continue its action. Or 
it may be so deficient in the red corpuscles, and so impover- 
ished as to be incapable of arousing the energies of the heart, 
and the patient dies with all the symptoms of anaemia. And 
then again, the stimulus may be sufficient to urge on the 
functional activity of the organs ; but from some cause the 
muscular walls of the heart lose their power of contractility ; 
the organ fails to respond to its accustomed stimuli ; circula- 
tion is arrested thereby, and death takes place by asthenia. 

ASTHENIA. 

Means debility or a want of strength ; and it is generally in- 
duced by toxicohaemia. The poison may be taken directly 
into the system, or a blood poison may be generated from the 
leaven of contagion by zymosis. In either case the morbific 
agent is conveyed to the tissues by the circulation, and acts 
locally on the organs. It destroys the contractility of the 
muscular walls of the heart, thereby arresting the circulation ;, 
or it may so expend its force on the functions of the cerebel- 
lum as to cut off the supply of nerve force, which presides 
over the heart's action, and thus produce paralysis of the mus- 
cular fibers of the heart. In either case death takes place by 
syncope induced by asthenia. Death by asthenia is some- 
times caused by reflex action. Cases are on record where the 
heart has been ruptured by sudden and unexpected news, act- 
ing so powerfully upon the mind as to create such a shock to 



68 THEORY AND PRACTICE OF MEDICINE. 

the nervous system, that the delicate muscular fibers were 
torn asunder. All of the organs and tissues are supplied with 
nerves, that center in the cerebellum ; and which directly or 
indirectly preside over their functions. So if the mind, which 
has charge of this delicate but powerful apparatus, be sud- 
denly overwhelmed with some unexpected event, then the ner- 
vous centers and nerve fibers are surcharged, and a sudden 
shock is communicated to the muscles and organs over which 
they preside ; increasing their power of contractility, and the 
blood is thrown into the heart with such an increased momen- 
tum, that the organ in attempting to expel its contents is 
destroyed by its own effort. The circulation is cut short, and 
the patient dies of syncope. 

The anatomical condition of anaemia and asthenia differ 
in this ; that in the former, the heart and lungs are found to be 
nearly empty and collapsed, owing to the deficiency of blood 
in the system. In the latter, the lungs are found empty be- 
cause the heart having lost its power of contraction could not 
propel the blood into them ; and the respiratory function being 
partly under the control of nervous influence, respiration was 
kept up and the blood w T as carried out of the lungs, and by the 
force of gravity falls into the heart, which is found engorged. 
The left side is filled with scarlet or arterial, and the right 
with purple or venous blood. A broken heart is no myth. It 
is stated that a sea captain after a long voyage was returning 
home, and his mind was wrought up to the highest pitch of 
expectancy to see his beloved wife. As he approached the 
shore he was seen standing upon deck with spy-glass in hand 
scanning the wharf to see his beloved wife, but saw her not. 
As he landed he inquired of a friend about his wife, and when 
told that she w r as dead he fell lifeless upon the wdiarf. A post- 
mortem revealed the fact that the internal tissues of his heart 
were torn to shreds. 

APNCEA. 

This denotes absence of respiration. It is that condition 
called asphyxia by the older writers, or in common phrase it 



THEORY AND PRACTICE OF MEDICINE. 69 

is suffocation. There are many morbid conditions of the sys- 
tem that may interfere with respiration by excluding atmos- 
phere from the lungs. All diseases of the pharynx, larynx, 
bronchi, and lungs, or indeed all morbid conditions that has- 
ten an increased flow of venous blood into the lungs, and that 
prevents its being arterialized, are a cause of apncea. The 
venous circulation is arrested in the pulmonary capillaries, 
stagnation of the blood takes place, and death is the result, 
unless speedily relieved. This then is the condition in which 
death takes place through the lungs. The lungs are found 
filled with dark venous blood, because oxygen is excluded by 
which it is arterialized ; and the respiratory movements being 
thereby arrested, there is no flow of arterial blood into the 
heart, and its action being rapid, the left cavity is almost en- 
tirely empty, while the vena cava and right side are filled with 
dark venous blood. Thus you see, that the anatomical con- 
dition of asthenia and apncea are entirely different, and there- 
fore clearly demonstrates the fact, that death does take place 
both through the heart and lungs, and from entirely different 
causes. In the former the heart ceases to beat before respira- 
tion stops ; in the latter the respiration is arrested before the 
heart's action. 

The third mode by which death enters the system is 
through the brain, and is the effect of that condition we call 
coma. 

COMA. 

Is that morbid state of the cerebral system, which is charac- 
terized by a profound state of sleep, or stupor, from which it 
is difficult to rouse the patient. As the nervous centers or 
cerebellum preside over the functions of respiration, circula- 
tion, digestion, assimilation, secretion, excretion, and sensa- 
tion, it will be readily seen what the result would be if coma 
supervene. Death beginning at the brain spreads to every 
tissue and organ. Respiration is embarrassed, circulation is 
languid, sensation is diminished, digestion and assimilation 



JO THEORY AND PRACTICE OF MEDICINE. 

are perverted, the secretory and excretory functions are de- 
ranged ; and life ebbs away, and the patient is said to be in a 
comatose condition. Death through the brain, or by coma, is 
of frequent occurrence. All diseases of the cerebro-spinal sys- 
tem, and many of the vegetable and animal poisons, produce 
death in this way. 

Thus then, it may be demonstrated that death must take 
place, whatever may be the character of the disease, through 
a failure of the circulation, respiration, and a prostration of the 
nervous centers. These modes open up an interesting field 
for study and investigation ; for if we know certainly the 
mode and channel through which death is approaching, we 
may often obstruct its way, and check its untimely visit, by 
the use of the means at our command. 

What are we to understand by the term death? Authors 
tell us that it is the extinction of life. That, however, is not 
true from a biological stand point, for life force must be as 
eternal as God himself, and it cannot be extinguished. Pas- 
teur, the learned French biologist, says that he found life in 
what was called dead matter. Death, then, is only a separa- 
tion of soul and body, and not an extinction, or annihilation 
of life force. When life ceases to animate the human organ- 
ism, then the body begins to disintegrate ; its form is changed, 
and gives place to its ultimate elements. That force which 
causes separation of soul and body has been termed death. As 
before stated that term does not express the true meaning of 
the process. But being a force set in motion by disease and 
which causes dissolution, it has been expressed by the word 
death as the shortest term expressive of the process of separa- 
tion. 

DISEASES. 

This then brings us to the consideration of disease and 
its treatment. Before taking up that subject I want to say 
a few words to you on the subject of your conduct in the pres- 



THEORY AND PRACTICE OF MEDICINE. J I 

ence of your patients. You should not enter the sick-room 
of a male or female in an abrupt or too familiar manner. 
Enter quietly with a bright and cheerful countenance, and 
thus inspire your patients with hope from the beginning. 

Your appearance will first excite the patient and cause 
the pulse to rise to ioo° or 120 , whereas after the patient is 
composed it ma)- be only a little above the normal. Hence 
if you examine the pulse on first entering the room you may 
make a mistake in diagnosis, both as to the pathological con- 
dition, and the proper remedy. 

There should be no whispering in the room, but every one 
should speak in a clear tone so that the patient can hear, dis- 
tinctly, every thing that is said. No noise should be allowed 
in or near the sick room. In a word, the patient must be kept 
quiet, and made as comfortable and happy as possible. Let 
no long-faced despondent persons enter the room under any 
plea. Keep out all company except those who have the care 
of the patient. Never refuse to admit a minister of the Gospel 
to the sick room ; for his presence will often do more good 
than your medicine. Faith and hope constitute the anchor of 
eternal rest, and they often become grand psycho-therapeutic 
agents for the bod)'. Therefore cultivate them in the minds 
of your patients. 

Vulgarity is an element that should never enter the sick- 
room. No smutty jokes should ever be allowed. It has been 
said, by some one, that of all men, a physician should be a 
gentleman. You as physicians will often have committed to 
your confidence the most delicate secrets of a family, and you 
should hold them as sacred as your own honor, and no con- 
sideration should tempt you to divulge them. 

A physician should be sober, kind, and attentive to his 
business. You should never take whiskey, opium and cocaine 
before visiting a patient, especially if the case is obscure and 
hard to diagnose. If you cannot diagnose the symptoms of 
the disease correctly, then you will be unable to diagnose the 
indicated remedy. You must remember that the above men- 



72 



THEORY AND PRACTICE OF MEDICINE. 



tioned narcotics befog the memory and render the physician 
incapable of becoming master of the situation. 

Diseases may be classified under three grand divisions 
and all the ills to which man has become heir may fall un- 
der the head of one or the other of those natural orders. 
They are called general, constitutional, and local diseases. 

The following tabular view will illustrate the classifica- 
tion and their subdivisions. 



First General Disease 
or Idiopathic Fevers, <J 



Divided. 



r Continued 



Periodical 



Eruptive . . 



Sub-divided. 
Simple or Irritative Fever 
Typhoid Fever, 
Typhus Fever, 
Relapsing Fever, 
Diphtheritic Fever, 
Milk Fever, 

Intermittent Fever, 
Remittent Fever, 
Yellow Fever. 

Variola, 
Rubeola, 
Scarlatina, 
Dengue, 
Erysipelas, 
^ Plague. 



Constitutional Diseases. 



( Tuberculosis, 

J Rheumatism, 

\ Gout, and 

[_ Syphilis. 



The distinguishing characteristic of general and local dis- 
eases is this, that in the former the fever is primary ; and if 
any inflammatory action, or pathological change, is set up in 
any organ, it is secondary, or the result of the specific fever. 
But in the latter, the local lesion is the primary cause, and 
the fever is secondary ; or, in other words, the fever in general 
disease is idiopathic, while in the local it is symptomatic. 

General disease first pervades the whole system, all the 



THEORY AND PRACTICE OF MEDICINE. 73 

functions are more or less affected by it, and it generally 
selects an organ or tissue upon which to spend its force. 
Whereas local disease manifests itself first in some particular 
part, as its base from which to operate and bring the system 
under its control. Hence it is that so many diseases receive 
their nomenclature from the character of the local lesion. 
Constitutional disease is the result of a peculiar diathesis, in- 
herited or acquired, which may act as a predisposing cause of 
a distemper that may be developed by a specific or an excit- 
ing cause. 

Your attention is now directed to the diseases included in 
our first division. And the first subject that demands our 
consideration is the nature and cause of fever. The question 
naturally arises in the mind of the medical student, what is 
fever? It may be answered that it is a disturbance of all the 
functions of the system called innervation, altered circulation 
and secretion. But as to the nature of fever we know but 
little. The subject has engaged the attention of the profes- 
sion from the days of Hippocrates to the present time, and 
still our knowledge is imperfect. Many theories have been 
advanced, from time to time, to explain its nature. The first 
of which was the humoral pathology as taught by Hippoc- 
rates and Galen. They believed that it was the result of a 
deranged condition of the fluids. This opinion prevailed until 
the days of Celsus, when he modified it somewhat, and claim- 
ed that fever was simply a disease of the whole body. Syden- 
ham took a similar view, and taught that a disease was no 
more than a vigorous effort of nature to throw off the mor- 
bific matter, and thus recover the patient. That is to say, 
fever is the result of that antagonism set up between the 
morbific agent and the vital properties of the elementary tis- 
sues of the body. If the plastic condition of the patient be 
normal, and his surroundings favorable, then nature over- 
comes the offending difficulty and casts it out of the system, 
and resolution takes place immediately. But if the aplastic 
and hyperplastic diathesis be present and zymosis vigorous, 



74 THEORY AND PRACTICE OF MEDICINE. 

then nature is overpowered and a pathological change takes 
place, both in the fluids and solids, by which an idiopathic or 
a symptomatic fever is the result. This I believe to be the 
true theory, yet we know no more about how the temperature 
is increased than we do about the heat that is generated by 
the union of two chemical elements. The humoral theory 
prevailed until the days of Hofman and Cullen. The former 
was the first to point to the solids as the seat of disease ; and he 
taught that fever was the result of a powerful reaction which 
was set up in the system by an effort of nature to overcome 
the spasm of the capillaries produced by morbid action of 
the nervous system. Cullen, however, was the first to over- 
turn humoralism and enlist the attention of the profession 
to the nervous theory. He believed that the etiological agent 
acted as a sedative upon the nervous centers, thereby dimin- 
ishing their energy on the functional activity of the organs 
and tissues ; that a powerful reaction takes place by an effort 
of the vital affinity of the parts to overcome debility, and by 
that act heat or fever is produced. Thus the controversy has 
continued from age to age with able advocates on either side ; 
but the profession is fast settling down on the belief that the 
blood is the laboratory where heat is generated by catalysis. 

CAUSE OE FEVER. 

The exciting cause of fever may be general and local. If 
general, they are said to be epidemic ; if local, endemic. An 
epidemic influence is an electrical change or condition of the 
air in which a number of individuals, remote from each other, 
may be attacked by a certain form of disease, and run a simi- 
lar course in each. An endemic disease is one that is pro- 
duced by local causes, and confined to certain persons or local 
districts. There are also contagious causes. We understand 
contagion to be a zymotic agent which is conveyed into the 
blood, where zymosis takes place, and a blood poison is gen- 
erated, by which the whole system is brought under its influ- 



THEORY AND PRACTICE OF MEDICINE. 75 

ence ; and the patient is then in that condition by which the 
disease can be communicated to others by contact or otherwise. 

The continued fevers are caused by decomposition of ani- 
mal matter, animal emu via, deoxydation of the air in narrow 
streets of large cities, jails, and emigrant ships. Periodical 
fevers are caused by decomposition of vegetable matter. Erup- 
tive fevers are caused by the leaven of contagion. 

The general diagnostic distinction between continued and 
periodical fevers consist in this, that the continued come on 
slowly with mild symptoms for a week or ten days before the 
patient is fairly prostrated. The pulse is only moderately 
quick ; tongue is covered with a thin whitish fur, increasing 
in thickness towards the center. There are slight chills ; an 
aversion to motion both mental and physical ; and suscepti- 
bility is impaired. If vomiting occurs it is only an ejection 
of the drinks ; no bile or offensive matter is thrown up. On 
the other hand, periodical fevers come on suddenly with vio- 
lent chills and shivering, and a high fever and severe pain ; 
susceptibility is unimpaired, tongue covered with a thick 
darkish fur which is sometimes a little yellow. So if you are 
called to see a patient, and find that he was taken very sud- 
denly ill, who but a few hours previous was apparently well, 
then you may know that you have not a case of continued 
fever, and must look to the list of periodical and local mala- 
dies for your diagnosis. 

CONTAGIOUS. 

Of the continued fevers only the typhus and relapsing are 
contagious, and they are only contracted by those who are in 
the aplastic condition. There is no positive evidence that 
typhoid fever is contagious. It was so considered by the older 
authors, but it was because they were unable to draw the line 
of distinction between typhoid and typhus. Since the days of 
Ivouis the distinguishing characteristics have been made plain. 
The fact of several members of the same family having typhoid 
fever is no evidence of its beings contagious. Neither is the 



j6 THEORY AND PRACTICE OF MEDICINE. 

fact of persons visiting the patient from a healthy locality, and 
then returning home to have the disease, an evidence of their 
having contracted it by contagion — unless we call all causes 
of disease contagion. It simply proves that they remained 
long enough under the influence of the local cause to change 
their diathesis, and place them in that condition which is sus- 
ceptible of endemic diseases. Then again, the care and anx- 
iety manifested by the family for the sick member, loss of 
sleep, bad ventilation of his room, and the constant breathing 
of the exhalations from the patient, are predisposing causes, 
and any person being kept in that condition for any length of 
time must evidently take the fever, or undergo a pathological 
change of a typhoid character. But if the patient is kept 
clean and his chamber thoroughly ventilated night and day, 
there is no danger of any one contracting the disease by visit- 
ing him for a short time each day. For the system must first 
be brought under the control of the same endemic or epidemic 
influence, before it can be attacked by the same form of dis- 
ease. But, on the other hand, contagion is liable to attack 
any person w T ith the smallest amount of exposure. That is 
to say, if a person is in the aplastic diathesis, and he takes 
but one inhalation from the sick room, then a disease will be 
developed similar to the one from which the exhalation 
sprang. Such is not the case with non-contagious diseases. 
A surgeon may visit a case of traumatic erysipelas and dress 
it daily without having the least symptom develop in his 
person, and yet if a patient with a fresh wound is placed in 
the same ward, erysipelas will probably develop in the wound 
within twenty-four or thirty-six hours. Thus, then, we must 
keep in mind the difference between contagion and infection 
or inoculation. For in either case timely warning from the 
attending physician may prevent the spread of disease, or 
save some one from inoculation. Many patients often have 
to suffer from a want of proper nursing owing to the fact that 
many physicians classify all diseases as contagious, and hence 
the fear of nurses. 



THEORY AND PRACTICE OF MEDICINE. J J 

There is a wide difference between the virus of contagion 
and the agents of endemic and epidemic diseases, and until 
we are able to make this distinction we are liable to commit 
an error in regard to the contagiousness and non-contagious- 
ness of certain forms of disease. 

I have thus dwelt at considerable length on the history of 
medicine, diatheses, etiology, diagnosis, prognosis, elementary 
principles of pathology, modes of death, and classification of 
diseases, in order to lay a firm foundation upon which to build 
the true science of Homoeopathic medicine, and thus prepare 
the student to enter upon the study of diseases and their treat- 
ment in a scientific and practical manner. This then brings 
us to the consideration of practical medicine. 



PRACTICE OF MEDICINE 



INFLAMMATION. 

I NOW call your attention to the subject of inflammation. 
According to my arrangements, or classification, inflamma- 
tion would come under the head of local diseases, but as we 
often meet with it as a complication, or result of a general 
disease, I deem it best to take up the subject and discuss it, 
before going any further, so that you may understand the 
nature and treatment of inflammation in whatever disease, 
stage or condition you may find it. Inflammation comes 
from iiiflammo, to burn. It is that pathological condition of 
an organ or a part, which is characterized by heat, redness, 
swelling, and pain. It may be either acute, sub-acute and 
chronic. It may also be active or passive, and is preceded 
by a morbid condition of the tissues called irritation and 
congestion. 

Symptoms. — Inflammation is characterized by five 
stages. I. Heat, and diminished flow of blood through the 
part. 2. Fever. 3. Infiltration of serum through the tissues 
and decay of cells. 4. Suppuration. 5. Gangrene. 

The primary symptoms may be seen in the following 
table. 



Inflammation. 



Irritation, 

Congestion. 

Heat, 

Redness, 

Swelling, 

Pain. 

f Irritation, 
Heat is Produced by j Congestion. 

f Redness, 
Congestion Causes < Swelling, 

Pain. 



THEORY AND PRACTICE OF MEDICINE. 79 

Irritation comes from irrito, to excite, or in other words, 
it is a morbid irritability of the elementary tissues, and is 
caused by an over stimulus of the elementary properties of 
the tissues. That excess of stimuli may be directly commu- 
nicated to the part by a morbid condition of the blood, or by 
reflex action. 

You will notice that I use the term stimuli to express the 
plural of stimulants furnished by the elementary properties 
of the tissues. This term was used by Moeler to express the 
difference between the normal stimulants of the organic 
functions, and the artificial stimulants used in medicine. I 
think the term so appropriate that I continue its use. Prop- 
erly speaking the term stimulants refers only to alcoholic and 
other medicinal agents. While the term stimuli, as used by 
Moeler, refers only to the physiological agencies which stim- 
ulate the organic functions or excites them to a normal action. 
You must not forget that external agencies may so affect the 
physiological stimuli as to produce a morbid stimulation, and 
hence irritation and congestion will be the result. 

Congestion is that abnormal condition of the capillaries 
of a part in which they are greatly distended. If the blood 
accumulates slowly, it is said to be 2, passive congestion; but 
if there is an increased flow of blood to the part it is said to 
be active. The increased flow of blood to the part causes an 
accumulation of fibrin in the part, consequently circulation is 
increased, and infiltration and effusion takes place, producing 
swelling and pain. 

We may have irritation and congestion without inflamma- 
tion ; but we cannot have the latter without the former. Some 
of the most troublesome cases that we have to deal with are 
from irritation. The irritation of the stomach, spine, and 
uterus of nervous females are good illustrations. But a part 
cannot remain long in a congested state, without inflamma- 
tion supervening. Therefore, in all threatened cases of in- 
flammation we should endeavor to arrest the disease in the 
congestive stage by the means hereafter to be noticed. The 



80 THEORY AND PRACTICE OF MEDICINE. 

four stages of inflammation may be seen in the following table : 

i. Heat, diminished flow of blood through the part. 
c j 2. Infiltration, and decay of cells. 

oTAGES . . . . \ . 

3. Suppuration. 

4. Gangrene. 



Diagnosis. 



1. Stage, irritation of the part, 

2. Stage is known by pain and swelling, 

3. Suppuration is announced by rigors, 

4. Gangrene, the parts look dark and discharge an 

offensive ichor. 



The first symptoms we have, then, is an irritation of the 
organ or tissue, with a diminished flow of blood through the 
part, and an increased circulation to the part ; which so modi- 
fies the functions as to cause a feeling of cold or chilliness ; the 
pulse is full, and becomes bounding as the disease advances ; 
the tongue is furred and dry, and at last becomes brown. 
The second stage is known to have taken place by the pain 
and swelling. The infiltrated serum and cells undergo a 
change, and decay. The third or suppurative stage is known 
to have set in by the supervention of rigors. In this stage, 
disintegration of the fluids first takes place ; then the tissues 
easily break down, and undergo a putrefactive process by which 
pus is formed. If the pus is contained within a circumscribed 
cavity, it is called an abscess ; but if the parts are open and 
sloughing, it is called an ulcer. It is sometimes difficult to 
tell whether the fluids from internal organs contain pus or 
not. Healthy pus contains pus globules, albumen, and oil. 
It may be distinguished by placing it under the microscope, 
when the pus globules may be seen floating in the fluid. The 
fourth stage, or gangrene, may or may not supervene an attack 
of inflammation. It depends on the diathesis of the patient. 
If gangrene sets in the parts look dark and discharge an offen- 
sive ichor. If this condition is not speedily corrected, the pulse 
grows quick and feeble, the patient is depressed, subsultus ten- 
dinum comes on, and death closes the scene. 



THEORY AND PRACTICE OF MEDICINE. 



8l 



Cause. — The fredisfosing causes are certain temper- 
merits and diatheses, and debility by whatever produced. The 
exciting causes are wounds, operations, toxicohsemia, heat, 
cold, and whatever irritates the parts. 

Pathology. — Inflammation produces : ist. Perversion of 
the fluids of the parts, and of the affinity of the tissues and 
fluids ; 2nd. Disorders, sensation and motion, producing neu- 
ralgia of the part ; 3rd. Irritation in some distant organ ; and, 
4th. Disordered blood. 

There are three grades of inflammation, which produce 
the following pathological condition or results : 



Pathology of Inflammation, 

1 st, f Accumulation of Blood, 

Sthenic X Susceptibility, Normal . . . 

I^Vital Affinity Increased. 

2nd, (Accumulation of Blood. 

Asthenic X Susceptibility, Increased 

y Vital Affinity Diminished 

3rd, (Accumulation of Blood. 

Specific X Susceptibility, Increased . 

(^ Vital Affinity, Perverted . 



Dep. of Material. 
. ist, Hyperplastic. 
.2nd, Plastic. 



ist, Plastic Mat'l. 
2nd, Aplastic. 



Aplastic. 
Malignant. 



Sthenic comes from the Greek word sthenos, which means 
strength. It is a term expressive of organic excitement, and 
is therefore used to express the character of those diseases 
which are produced by accumulated excitability. 

The sthenic grade is characterized by high arterial ex- 
citement, and is found in the plastic and hyperplastic diath- 
eses. The deposit in the inflamed parts corresponds with the 
plasticity of the patient 

It will be observed, that in each grade there is an accumu- 
lation of blood in the parts. But the character of the inflam- 
mation and the deposit depends upon the susceptibility and 
vital affinity of the tissues and the diathesis of the patient 
Thus, in the sthenic grade, susceptibility is normal and vital 



82 THEORY AND PRACTICE OF MEDICINE. 

affinity is increased ; thereby giving a hyperplastic and plas- 
tic deposit of an organizable material. This accounts for the 
large firm swelling that accompanies this grade, and for the 
large growth of tumors. There is a building up of the tis- 
sues instead of breaking them down as is the case in the 
other grades. 

The asthenic is a lower grade of inflammation ; conse- 
quently the arterial excitement is not so high. It may attack 
the plastic and aplastic diatheses. In either case, if suscep- 
tibility is increased, and vital affinity is diminished, we will 
have a deposit correspondingly. 

Specific is a term used to express a low grade of inflam- 
mation, which only attacks the aplastic diathesis and which 
is produced by some peculiar virus. In this grade suscepti- 
bility is greatly increased, and vital affinity perverted ; and 
there is a deposit of aplastic material which is incapable of 
taking on, or assisting in organic life, and readily putrefies. 
Inflammation of the sthenic grade with hyperplastic deposit 
seldom or never suppurates, but ends in resolution, leaving 
the parts sometimes thickened ; or it may end in death by an 
infiltration of serum into some of the internal organs. The 
asthenic grade, with plastic deposit, mostly ends in resolu- 
tion, or suppurates very slowly with a hard inflamed base, 
inclined to a purple crimson. 

The specific grade is aplastic, and suppurates easily, and 
often ends in gangrene. The inflamed parts are soft and 
inclined to a scarlet tint. Rheumatic inflammation is an ex- 
ample of the hyperplastic grade ; carbuncle of the plastic ; 
and erysipelas and malignant small-pox of the aplastic. If in- 
flammation of the sthenic grade takes hold of the plastic dia- 
thesis, when it is removed it leaves the parts in a more normal 
condition than either of the others. 

Treatment. — The first indication is to diminish the 
flow of blood to the part and overcome morbid susceptibility ; 
2nd. To ward off suppuration ; 3rd. To counteract specific 
action. 



THEORY AND PRACTICE OE MEDICINE. 83 

i. Sthenic Grade. — Aconite, apis, belladonna, gelsem- 
ium, veratrnm zriride These are the only agents we need 
in the sthenic, grade of inflammation in the hyperplastic and 
plastic patients ; for suppuration never takes place in the hy- 
perplastic diathesis, and rarely in the plastic. Absolute rest 
is of the highest importance in the treatment of inflammation. 
The patient should be kept in the horizontal position, and 
have a constant supply of fresh air. All company should be 
excluded except the nurse and those whom the patient wants 
to see. 

Asthenic Grade. — Aconite, apis, arsenicum, gelsemium y 
hepar sidphuris, silicia. These agents in the higher poten- 
cies will often ward off suppuration, but if they fail, then if 
given in the lower potencies, they will hasten the suppurative 
process. 

Specific Grade. — Arseniciun, calcarea carb, china, sulph. 

Nourishments and Stimulants. — Beef essence, coffee, 
with malted milk, cooked fruits, rice soups, etc. Give animal 
diet for aplastic and specific grades. Give more vegetables in 
hyperplastic and sthenic grades. 



SIMPLE CONTINUED or IRRITATIVE FEVER. 

This is the first of the group of idiopathic fevers to which 
I call your attention. It is a disease which manifests all the 
characteristics of fever in general, except in its modification. 
It sets in with feelings of indisposition ; coming on rather 
abruptly, and after lasting for a longer, or shorter period, 
slight chilliness is felt creeping over the body, amounting to 
a momentary shudder, and a feeling as if cold had been sud- 
denly applied to the back. This feeling is soon succeeded by 
flashes of heat, which become general ; the head and face are 
hot and dry ; the eyes are red ; the pulse becomes frequent 
and bounding. These symptoms last from twenty-four to 
forty hours, and disappear rapidly with or without treatment. 



S4 THEORY AND PRACTICE OF MEDICINE. 

The exciting cause of this disease is supposed to be exposure 
to cold or vicissitudes of climate ; fatigue, mental anxiety, or 
errors in clothing and diet 

Treatment. — The treatment of this disease is very sim- 
ple, often a glass of ice water or lemonade, with cold sponging 
is sufficient to arrest the fever in a few hours. But generally it 
needs medication, and the therapeutic indication is to lessen 
the amount of heat, diminish the rapidity of the circulation, 
and remove the irritation. These indications are readily ful- 
filled by the use of aconite and gelsemium. 

I wish now to impress one important fact on you before 
we go any further, and that is, never treat any disease by its 
name or in a promiscuous way. But treat ever}' case in ac- 
cordance with its pathological and general symptoms. In 
other words, examine every patient carefully, and gather even- 
symptom, and then compare them with the physiological 
symptoms produced by medicines. In this way you make 
your diagnosis between the remedies, so as to ascertain which 
of the medicinal agents will produce physiological symptoms 
similar to those of the patient That question being satisfac- 
torily settled in your mind then you are prepared to treat the 
case intelligently and successfully. It matters not at what 
stage of the disease you are called in, you must treat the case 
in accordance with the symptoms present. That is to say, if 
there is fever with a full bounding pulse, with intense thirst 
for large draughts of water at short intervals, then aconite is 
your remedy, it matters not at what stage of the disease those 
symptoms are developed. But if you find a patient with fever, 
and the face is flushed, red and swollen, or of a purplish hue, 
and if he complains of intense thirst, but only takes a sip or 
two at a time, and craves it often, then arsenicum is the remedy 
par excellence. 

I remember being called to see a case of inflammation of 
the eyes ; after using the remedies recommended for sore 
eyes for two days, with but little improvement, I was told 
that the patieut had intense thirst for small quantities of water 



THEORY AND PRACTICE OF MEDICINE. 85 

at short intervals. I then had the key-note of the case and 
gave arsenicum, and the disease began to abate in a few 
hours. If a patient has fever, face red, eyes red and staring, 
head hot, with delirium, and restlessness, then you must look 
to belladonna for relief. On the other hand, if a feverish 
patient craves large quantities of water at long intervals, and 
is averse to exercise, or feels worse when moving, then 
bryonia is homoeopathic to that condition, and will, almost 
always give speedy relief. A gelsemium fever patient is 
averse to exercise, feels languid, with pain in the back, and 
back of head. Gelsemium seems to be more adapted to fevers 
in warm climates, while aconite acts better in cold climates. 
Veratrum viride is a grand fever remedy ; it is indicated 
where there is brain trouble, and nausea, with a full, hard 
pulse, with violent pain in the back part of head. 

These six fever remedies will cover all grades of fever, if 
the organs are not so far involved by pathological change, as 
to retard their functional activity. 

The following are six valuable fever remedies : 

Aconite. — Full bounding pulse, intense thirst for large 
draughts at short intervals. 

Arsenicum. — Fever, flushed face of a red, swollen and 
purplish hue, and wants a sip of water at short intervals. 

Belladonna. — Fever with delirium, head hot, face red, 
eyes red and staring, with restlessness. 

Bryonia. — Fever, patient worse when moving, craves large 
draughts of water at long intervals. 

Gelsemium. — Fever, averse to exercise, feels languid, with 
pain in back, and back of head. 

Veratrum viride. — Full bounding pulse, nausea, with 
pain in back part of head. 

While I shall mention, alphabetically, the therapeutic 
agents that may be called for in each particular disease, yet 
you must select the indicated remedy to cover the totality of 
the patient's symptoms in each particular case. 

I have, thus far, said nothing as to the potency or dose to 



86 THEORY AND PRACTICE OF MEDICINE. 

be given. That subject should be left to the judgment of 
each practitioner. I can say this, however, as I had practiced 
allopathy twenty years before I became a homoeopath, it was 
difficult for me at first to get above the second potency. I 
soon learned by experience that I had far better success from 
the third to the thirtieth in acute diseases, and from the thir- 
tieth to the two hundreth for chronic cases. 

TYPHOID OR ENTERIC FEVER. 

This is an idiopathic disease, which is characterized by a 
forming stage, in which the zymotic agent is at work in the 
system from one to ten days before the fever is fully devel- 
oped. After the stage of febrile excitement has been estab- 
lished, the fever is continuous, and the disease runs its course 
with a diversity of symptoms that are characteristic of typhoid 
fever and its complications. This disease has long been 
known, but was imperfectly understood, until after the re- 
search of Iyouis, who established the fact of its constant ana- 
tomical and pathological peculiarity. The writers who pre- 
ceded him described it as a variety of typhus, and many of the 
European authors still so regard it. But their individuality 
or non-identity is settled beyond the shadow of a doubt. The 
nomenclature of this disease is vague. Writers have dili- 
gently sought for a name expressive of the pathological con- 
dition, but, as yet, none has been found free from objection. 
Probably the one that is least objectionable is " enteric ;" but 
this does not convey a definite idea of the character of the dis- 
ease under consideration. The term typhoid has become so 
popular, both among the people and profession, that it will be 
somewhat difficult to change it. But the distinction must 
ever be kept in view, between this fever and that secondary 
condition of many diseases, called the typhoid state. Typhoid 
fever is primarily a disease of the blood — that is to say, a zymo- 
tic action is set up in that fluid, by the presence of the typhoid 
ferment, or bacterium, by which the fever is developed. It 



THEORY AND PRACTICE OF MEDICINE. 87 

would be natural to suppose that all the tissues of the body 
would be more or less affected by a disease so general in its 
character. But it seems to have an affinity for certain locali- 
ties, through which the vital powers are more readily reached, 
and so depressed as frequently to cause the death of the patient. 

In whatever country typhoid fever prevails, or whatever 
the character of the epidemic, it has phenomena peculiarly its 
own. But each epidemic may differ in its local manifesta- 
tions. At one time, the disease may expend its force upon the 
organic functions collectively, while in other cases it may 
select a particular organ for its base of operations. The ab- 
dominal, cerebral, gastric, and respiratory apparatus are the 
parts most generally affected by typhoid fever. I will, there- 
fore, call your attention to six varieties or conditions, which 
demand special consideration. The first stage or premonitory 
symptoms are similar in all ; the complication or variety is 
soon developed, and gives to the disease its peculiar charac- 
teristics. The predisposing cause so depresses the vital affin- 
ity, and increases the susceptibility of the fluids and solids, 
that the morbific agent, in passing the rounds of the circula- 
tion, selects the weakest part, and there concentrates its forces. 

For convenience of description, I make the following tabu- 
lar view of this disease and its subdivisions : 



Typhoid Fever. < 



Simple Typhoid, 

Typho-enteric, 

Typho-cerebral, 

Typho-gastric, 

Typho-pneumonitis, 

Typho-malarial. 



Simple Typhoid. — I will first notice the clinical history 
and symptoms that belong to typhoid fever, independently of 
the complications to which I have referred. The approach 
of this disease is so gradual, that we are often unable to tell 
the precise time of its beginning. The patient complains of 
a general indisposition and lassitude ; there is an aversion to 



88 THEORY AND PRACTICE OF MEDICINE. 

exercise, both mental and physical ; the appetite is impaired ; 
the bowels are generally loose ; there may be but one stool 
during the twenty-four hours and that is thin and watery. If 
the bowels do not move the patient complains of borborygmus 
— a gurgling sound — and a small amount of physic will pro- 
duce the thin and watery stools so characteristic of this disease. 
There is a little tenderness in the right iliac region, which 
may be overlooked in the early stage, unless a close examina- 
tion be made by pressure. It is often so mild that the patient 
does not complain, and is not aware of any trouble in that 
region, until his attention is called to the fact by the physi- 
cian. Headache is often present, but this seldom in the early 
stage ; the tongue is covered with whitish fur ; the pulse is 
only a few beats above the normal standard ; slight pains are 
felt in the back and limbs. The patient often continues 
about his employment, in this condition, from one to ten 
days, when the symptoms grow worse, and he is compelled 
to take his bed. He then complains of a sense of chilliness, 
and sometimes of a severe chill, followed by fever and a dry, 
husky skin. The temperature of body ranges from 98.5°, in 
the morning, to 100. 5 °, in the evening ; the pulse is from 90 
to no per minute ; the appetite is entirely lost ; the bowels 
move more frequently ; and the temperature continues to rise 
to 101.5 , in the morning, and to 104.5 , ^ n the evening, as 
the disease advances. If the temperature rises to 105 , the 
disease is of a grave character ; and if it goes above 105 °, 
the patient is in great danger, and generally dies. The 
tongue becomes thickly coated ; sordes gather around the 
teeth ; the countenance assumes a dull expression ; a low, 
muttering delirium sets in ; the patient is nervous and has a 
buzzing in the ears, which so affects the hearing as often to 
produce deafness ; he sometimes dozes, and starts up in a state 
of alarm ; he is easily aroused, and answers questions, but 
soon relapses into a somnolent condition. If the abdomen be 
examined closely, between the seventh and fifteenth day of 
the progress of the disease, a few red spots will generally be 



THEORY AND PRACTICE OF MEDICINE. 89 

found upon it, which may extend to the breast, and also to 
the extremities. This is called the rose-colored eruption, 
and is one of the characteristic signs of typhoid fever. As 
the disease advances, the patient becomes delirious ; the feces 
are passed involuntarily ; he becomes comatose, picking at the 
bed-clothes or imaginary objects ; slipping down in the bed ; 
the skin is bathed with a clammy sweat ; the pulse grows 
quick and feeble ; subsultus tendinum is observed ; and death 
often takes place in from six to twenty-one days, from the 
time the patient takes to his bed. Although this is the course 
of the fatal cases, yet a large majority of the patients, if seen 
in time, and the appropriate treatment adopted, begin to im- 
prove about the ninth, fourteenth, or twenty-first day. The 
tongue begins to clean from the tip and edges ; the pulse grows 
less frequent ; the skin is cooler ; the mind becomes clear ; 
the patient sleeps, awakes, and finds himself refreshed ; the 
bowels return to their normal functions ; there is a desire and 
relish for food ; and convalescence is established. The tongue 
sometimes, instead of cleaning from the tip and edges, throws 
off its coat in flakes from the centre. In this condition, the 
prognosis is favorable, but the convalescence is more tedious. 
This, then, is the beginning, progress, and termination of 
simple, uncomplicated typhoid fever. But a more dangerous 
variety often prevails, or the simple may merge into or put on 
a more violent form, which is denominated Typho-Bnteric. 

Typho-Enteric. — This differs from the former in the 
degree of lesion in the intestine only. In this variety the 
diarrhea is the first and most constant symptom. The patient 
complains of tenderness of the bowels ; the stools are frequent, 
thin, and watery, and of a brownish cast ; the abdomen be- 
comes tympanitic, with a gurgling sound in the right iliac 
region, when pressure is made upon that part ; the urine is 
scanty and highly colored, and is sometimes suppressed or re- 
tained in the bladder. The tongue, which at first was cover- 
ed with a thin, whitish fur, now becomes brown and dry in 



90 THEORY AND PRACTICE OF MEDICINE. 

the centre, with a thicker coat; the tip and edges are of a 
crimson hue, and sordes gather around the lips and teeth. As 
the disease progresses the abdomen becomes more distended ; 
the stools are more copious and contain dark, fetid blood, 
which is an evidence of disintegration of the structures of 
Peyer's glands. Sometimes the hemorrhage is so great, that 
the patient is prostrated in a few hours ; but more generally, 
ulceration of the coats of the ilium takes place gradually, with 
increased tenderness of the bowels ; and after a longer or 
shorter continuance of these symptoms, the patient is suddenly 
seized with a violent pain in the right iliac region ; he looks 
distressed and anxious. These symptoms point to perforation 
of the intestine, with extravasation of its contents into the 
peritoneal cavity, which produces inflammation of the perito- 
neum, and may cause death in from one to six days. How- 
ever, ulceration and perforation of the ilium does not always 
cause death. There are many cases of recovery on record. 
Patients often complain of a feeling as if though their bodies 
had been severed at the umbilicus ; and they are constantly 
trying to get the pieces together. They also complain of a 
pricking sensation as if the flesh had been pierced by thou- 
sands of needles. 

The next variety in the catalogue of complications is the 
cerebral type, cr Typho-Cerebral. 

Typho-Cerebral. — In this the head symptoms are more 
marked than in any other. The patient complains constant- 
ly of headache from the incipiency of the disease ; and as 
the fever and temperature of the body increases, he becomes 
wild and excited, and is soon delirious, and talking incoher- 
ently. The head is sometimes hot and dry ; the patient can- 
not sleep, and imagines that he is away from home, and is 
constantly arising from his couch, and attempts to make his 
escape through an open window or door, or sometimes falls 
helpless on the floor from exhaustion. The question natur- 
ally arises, whether the head symptoms are the result of 



THEORY AND PRACTICE OF MEDICINE. 9 1 

inflammation, or of functional derangement. It is believed 
that the latter is the pathological condition, in the majority 
of cases. For while persons have died, apparently, from the 
effect of the cerebral symptoms, post mortems proved the fact 
that the brain and its appendages were free from inflamma- 
tion, and that the characteristics of typhoid fever were man- 
ifest in the ilium ; thus proving, beyond a doubt, that what- 
ever may be the complication or symptoms, the specific agent 
by which the system is depressed, after changing the condi- 
tion of the blood, selects the glands of Peyer as the point 
from which its influence is communicated to the various 
organs and tissues, either directly through the circulation, or 
by reflex action. 

I do not wish to be understood as saying that there are no 
cases of inflammation of the brain and its meninges ever 
found in typhoid fever ; for there are exceptions to all general 
rules. But, in this disease, depression of the functions is the 
rule, and inflammation is the exception. 

According to my observation, the inflammatory or non- 
inflammatory character of the cerebral symptoms, in typhoid 
fever, may be established by the thermometer. In this dis- 
ease, the temperature varies in accordance with the degree of 
activity of the typhoid poison. There is always a difference 
of from i° to 2° F., between the evening and morning tem- 
peratures ; and this difference is always observed, whether 
the evening temperature is rising or falling. The tempera- 
ture gradually rises in the evening and falls in the morning, 
until the former reaches 104 , and the latter 103 °. When 
the temperature has reached these points, which is from the 
third to the sixth day, there is a decrease, and it often falls as 
low as 99. 5 , in the morning, and ioo°, in the evening. This 
fluctuation continues for a longer or shorter period, when the 
temperature may again go up, until it reaches 105 , in the 
evening, and 103 in the morning. Thus the fluctuations 
take place from time to time, and the oscillations of tempera- 
ture, between the evening and morning, continue with the 



92 THEORY AND PRACTICE OF MEDICINE. 

same degree of regularity, until the beginning of the stage of 
convalescence, when the difference of oscillation may reach 
from 3 to 5 . But, on the other hand, in local inflamma- 
tions, there is a gradual rise of the temperature, until the 
inflammation has reached its acme. And as the inflamma- 
tion begins to decline, the temperature falls rapidly until the 
standard of health is again reached. 

The reason that there is not so great a lesion of the ilium, 
in the typho-cerebral type of typhoid fever as there is in the 
typho-enteric, is because the force of the disease is called 
from the bowel to some distant organ. And there it may ex- 
ert such an influence over the organic functions, as to increase 
susceptibility, destroy vital affinity of the parts, and produce 
death by depression of the vital powers. A somewhat com- 
mon and very dangerous complication is called Typho- 
Gastric. 

Typho-Gastric. — Soon after the characteristic symptoms 
of typhoid fever have been developed, the patient complains 
of nausea and vomiting, and of a load and pressure in the 
epigastrium. When vomiting occurs, it is only an ejection 
of the fluids that have been taken into the stomach. The 
fluids that are thrown up are sometimes of a yellowish cast, 
owing to regurgitation of bile. The pulse is quick and full ; 
the skin is dry and hot ; the tongue is covered with a dirty 
white fur, and is a little brown in the center. This form of 
typhoid fever is the most dangerous ; and it may be mistaken 
for gastritis. It frequently destroys life in a few days. 
Owing to the fact that there is such a strong impression made 
upon the stomach ; the bowels are not so loose as they are in 
the other varieties ; and thus we may overlook the intestinal 
symptoms. If, however, they be examined carefully, the ten- 
derness may be detected near the ileocsecal valve. 

Another variety of typhoid fever often occurs in certain 
latitudes during the winter and spring, which has been 
named Typho-Pneumonitis. 



THEORY AND PRACTICE OF MEDICINE. 93 

Typho-Pneumonitis. — I have placed typhoid-pneumonia 
in the classification of continued fevers, because the idiopathic 
fever precedes the inflammation of the lungs ; and the pneu- 
monia is symptomatic, and therefore secondary to and a com- 
plication of typhoid fever. Whereas, in pneumonia proper, 
we may have a typhoid condition supervening the disease of 
the lungs ; therefore, one is the result or consequence of an 
idiopathic fever, and the other the effect of a primary local 
lesion. This disease has frequently prevailed as an epidemic, 
in some portions of the United States, and it is sometimes at- 
tended with very fatal results. After the usual premonitory 
symptoms of typhoid fever have lasted for a longer or shorter 
period, the patient complains of a sense of chilliness, fol- 
lowed by a dryer and hotter skin ; the secretions are locked up ; 
the tongue is dry and of a brownish cast ; the face is flushed 
and of a bluish tint ; the pulse is strong, full and rapid ; the 
countenance is dull and the respiration is quick. This latter 
symptom is peculiar to pectoral troubles, and calls our atten- 
tion to a complication of pneumonia. If the ear be applied to 
the chest, a crepitant rale may generally be heard in the lower 
and posterior lobe of the right lung ; there is but little or no 
pain, and but little cough in the early stage. If there is pain, 
it is dull, and not the sharp pain of pneumonia proper. Some- 
times the symptoms are so slight, that the complication may 
be overlooked without the aid of auscultation. But as the 
disease advances, the force of the idiopathic fever seems to be 
concentrated on the lungs ; and we have cough and difficulty 
of breathing, as in primary pneumonia, but there is a greater 
degree of prostration. 

The last complication of typhoid fever to which I call your 
attention is Typho-Malarial. 

Typho-Malarial Fever. — This disease prevails endemi- 
cally and epidemically in malarial districts only, and partakes 
both of typhoid and malarial fevers. After the usual though 
aggravated symptoms of typhoid fever have lasted from three 



94 THEORY AND PRACTICE OF MEDICINE. 

to seven days, the patient complains of a cold sensation or 
severe chills, with aching of the back and limbs ; the tongne 
becomes coated in the center with a thick, brown fnr; the 
edges and tip have a glossy, red appearance. The bowels may 
be inclined to constipation or diarrhea, but generally the lat- 
ter. The patient is nervous, and as the disease approaches its 
acme, delirium sets in, and he soon sinks into a profound 
stupor, and death often takes place, in from seven to fifteen 
days after the chills make their appearance. There is one 
peculiarity about this disease that may lead the physician into 
error in diagnosis. The patient is found perspiring freely, 
and has all the appearance of having a malarial fever ; he com- 
plains of being chilly even while in this condition ; and the 
pulse is never less than no, and may reach 140, while he is 
sweating profusely ; the tongue is still dry, in this stage, and 
the temperature is not reduced. It has been observed that the 
cases which perspire copiously are the most dangerous and 
difficult to treat. As a general rule, if the patient perspires 
freely, the diarrhea is easily controlled ; but when the skin 
becomes dry, the bowel affection is very troublesome. The 
gastric and cerebral functions are generally deranged in this 
form of the disease ; nausea and vomiting are almost always 
present. There is no regularity in the appearance of the rose- 
colored eruption ; it may show itself on the seventh day, and 
from that to the twenty-sixth. I have generally found suda- 
mena over the body, instead of the rose-colored eruption on 
the abdomen. 

Some writers have described another variety, which comes 
on suddenly, with chills and remissions, similar to remittent 
fever, and followed by typhoid symptoms. I am inclined 
to believe that these are aggravated cases of remittent fever, 
which merge into a typhoid state. For in the cases which I 
have seen, there seemed to be a commingling of the symp- 
toms of typhoid and remittent fever, throughout the whole 
course of the disease — that is to say, the primary and general 
symptoms were characteristic of typhoid, and the incidental 



THEORY AND PRACTICE OF MEDICINE. 95 

fevers were those of remittent. During the summer of 1863, 
I treated seven cases in the northern part of Illinois. They 
were well-marked cases of typhoid fever in the beginning, 
and continued so through the first five or six days, after which 
the patient complained of chilly sensations, followed by a 
hotter and dryer skin. The pulse would often reach 140 per 
minute. This febrile excitement would sometimes continue 
for twelve or eighteen hours, when the patient would break 
out into a copious perspiration. I have seen patients per- 
spire freely for twenty-four hours, and then the skin would 
become hot and dry for the next twenty-four or thirty hours. 
I noticed that during the most profuse sweatings, the patients 
complained of being chilly, and would draw the covering 
around their necks. The pulse would fall only a few beats 
in this stage. The patients were inclined to be drowsy, but 
were easily aroused, and would soon relapse into a dreamy or 
half conscious state. The apparent regularity of the sweat- 
ing stage, and the character of the perspiration, gave evi- 
dence of the presence of marsh miasmata in the system. But 
every other symptom pointed unerringly to a typhoid poison. 
One of those patients died, and the others were from fourteen 
to twenty-one days before convalescence was established. 
Some cases run from three to six weeks. The liver is fre- 
quently deranged in this disease. The fluids ejected from the 
stomach are often colored with bile, and the conjunctiva has 
a yellowish cast. Hiccough is often a troublesome symptom, 
and is much more frequent in this than in the other varieties 
of typhoid fever. 

Causes. — The cause of typhoid fever is not well under- 
stood. There is no doubt that a specific agent is formed by 
the decomposition of animal matter, or a chemical change 
takes place in the exhalations from the human body, during 
sickness or close confinement, which acts as a predisposing 
cause. The exciting causes are vicissitudes of climate, errors 
in diet, mental anxiety, and whatever tends to increase sus- 
ceptibility of the system, and induce that peculiar condition 



96 THEORY AND PRACTICE OF MEDICINE. 

called the aplastic diathesis. When the disease occurs under 
these circumstances, and is confined to particular localities, it 
is said to be endemic. The epidemic form may be produced 
by an electrical change in the atmosphere, by which the vital 
powers of the inhabitants of cities and large territories are so 
depressed as to form a favorable medium by which the specific 
agent readily diffuses itself through wide districts; and all 
those who are affected by the predisposing cause, are easily 
brought under the control of the exciting cause, and are pros- 
trated by the fever. The morbific agent, bacillus, whatever 
it may be, does not affect or produce zymosis in the plastic 
system ; and the individual must first be brought under the 
epidemic influence, or his condition changed, before he is liable 
to an attack of typhoid fever. If, in certain geographical dis- 
tricts, the atmosphere becomes damp and heavy, with thick 
fogs remaining during the greater part of the day, and con- 
tinues for several days together, typhoid fever will be the pre- 
vailing disease, and will give all the evidence of an epidemic. 
This disease is thought to be most prevalent in autumn 
and winter. If it prevails in malarial districts, during the 
latter part of summer or early autumn, it is liable to put on a 
typho-malarial type. It appears that no age or sex is exempt 
from typhoid fever. From the investigations of Louis, it is 
found to be more frequent in those from twenty to twenty-five 
years of age. But it frequently occurs in children, at the age 
of eight and nine years. There are many persons who believe 
this disease to be contagious, but some of the ablest practi- 
tioners of Europe and America discard the theory. There is no 
doubt that the idea originated from the fact that it is some- 
times difficult to draw the line of distinction between typhus 
and an epidemic of typhoid fever. There is no positive evi- 
dence that typhoid fever is contagious. It was so considered 
by the older authors, but it was because they were unable to 
draw the line of distinction between typhoid and typhus. 
Since the days of Louis, the distinguishing characteristics 
have been made plain. The fact of several members of the 



THEORY AND PRACTICE OF MEDICINE. 97 

same family having typhoid fever, is no evidence of its being 
contagious. Neither is the fact of persons visiting the patient 
from a healthy locality, and then returning home to have the 
disease, an evidence of their having contracted it by conta- 
gion — unless we call all causes of disease contagion. It 
simply proves that they remained long enough under the in- 
fluence of the local causes to change their diathesis, and place 
them in that condition which is susceptible of endemic dis- 
eases. Then, again, the care and anxiety manifested by the 
family for the sick member, loss of sleep, bad ventilation of 
his room, and the constant breathing of the exhalations from 
the patient, are predisposing causes ; and any person being 
kept in that condition for any length of time, must evidently 
take the fever, or undergo a pathological change of the ty- 
phoid character. But if the patient is kept clean, and his 
chamber thoroughly ventilated night and day, there is no 
danger of any one contracting the disease by visiting him. 
For the system must first be brought under the control of the 
same endemic or epidemic influence before it can be attacked 
by the same form of disease. But, on the other hand, con- 
tagion is liable to attack any person, with the smallest amount 
of exposure. There is then a wide difference between the 
virus of contagion and the agent of endemic and epidemic 
diseases. And until we are able to make this distinction, we 
are liable to commit an error in regard to the contagiousness 
and non-contagiousness of certain diseases. 

During the winter of 1858 and 9, from two to three hun- 
dred students visited the typhoid fever wards of Mercy Hos- 
pital in Chicago, and notwithstanding the fact that they re- 
mained in those wards two hours every second or third day 
during a long epidemic, yet not one of them took the fever. 
One of our students, however, who did not attend the hos- 
pital, but spent late hours at night in the dissecting room, 
contrary to the advice of the faculty, took the fever and died. 
Thus demonstrating the fact that he remained so long in the 
dissecting room that his system was brought to the lowest de- 

7 



98 THEORY AND PRACTICE OF MEDICINE. 

gree of aplasticity compatible with life. He being in that 
condition, and typhoid being epidemic, the morbific agent, or 
bacilli, of the atmosphere as readily enters his system as if he 
had come in contact with them in the wards of the hospital. 
Thus the dissecting room was the predisposing cause, and the 
typhoid bacilli, in the atmosphere, the exciting canse of the 
development of typhoid fever ; and vital affinity being at so 
low an ebb the organic functions succumbed to the typhoid 
poison. 

Since preparing my lecture on typhoid fever I see by the 
medical journals that bacteriologists differ as to the cause of 
that disease. The Germans believe that typhoid fever is al- 
wavs caused bv a sino-le germ. This is the o-erm of Eberth, 
or it is sometimes called the Koch-Eberth germ. This bacil- 
lus forms an invisible growth on the potato. The Germans 
believe that typhoid fever is always caused by this germ and 
by no other. On the other hand, some of the French bacter- 
iologists believe that typhoid fever is caused by the bacillus 
coli communis, which is normally present in the intestines, 
and which, under certain conditions, acquires especial viru- 
lence, and sets up inflammatory action in the wall of the 
intestines. From this we would infer that the bacillus coli 
communis is a normal ingredient of Peyer's glands and they 
have their physiological functions. It would seem from this 
that it is only when their vital affinity is reduced by the 
aplastic condition of the system that external epidemic in- 
fluences cause them to set up a fermentative process and thus 
produce inflammation, and the disease is thus set in motion. 

Your patients will care but little what causes typhoid 
fever, and will anxiously inquire whether you can cure it or 
not. After all it is more important to inquire into the thera- 
peutics of a disease than its etiology. 

florbid Anatomy. — The almost constant pathological 
peculiarity of typhoid fever is to be found in the ilium, as the 
result of the fever poison. An irritation and congestion are 
set np in the glands of Peyer, which give them a thickened or 



THEORY AND PRACTICE OF MEDICINE. 99 

enlarged appearance ; and as the system is fully brought under 
the influence of the idiopathic fever, inflammation sets in ; 
disintegration takes place ; the glands become softened, and 
easily break down ; the follicular structure is lost ; and ulcers 
of varying size and color are the result. These ulcers have a 
tendency to heal even where perforation has taken place, and 
under appropriate treatment do frequently heal, and the patient 
recovers. This fact has been proved by post mortems, where 
patients have died of some other disease, many years after an 
attack of typhoid fever. 

It would be natural to suppose that, from the general effects 
of the blood poison, and the long continuance of the disease, 
the various organs and tissues of the body would undergo a 
pathological change before death. This we find to be the case. 
The liver, spleen, and mesenteric glands are found softened 
and enlarged ; the kidneys are in a morbid condition ; the 
pharynx, oesophagus, bronchi, lungs, stomach and heart, are 
more or less changed in color and structure. 

Diagnosis. — The diagnosis of this disease is sometimes 
difficult, owing to the fact that many of its symptoms are 
similar to those of other idiopathic fevers, and simulate those 
of local disease and morbid states. There are, however, some 
differential symptoms which serve and direct us to a correct 
conclusion. 

The watery evacuations and tympanitic bowels ; tender- 
ness over the iliac region, with a gurgling sound ; the thin, 
dirty white fur on the tongue, which after a few days becomes 
brown ; the rose-colored rash on the abdomen ; complete loss of 
appetite; the peculiar dullness of mind, and apathetic or 
dejected expression of countenance ; and enlargement of the 
spleen, are all diagnostic symptoms of typhoid fever, when 
taken in connection with the history of the case. The latter 
symptom is supposed to be pathognomonic, if it can be shown 
that the spleen w T as not enlarged previous to the attack then 
under consideration. 

The disease and conditions- most likelv to confuse the pin-- 



IOO 



THEORY AND PRACTICE OF MEDICINE. 



sician are the following : Typhus fever, enteritis, typhoid con- 
dition, remittent fever, gastritis, general debility, meningitis. 

Typhus. — The differential diagnosis of typhoid and typhus 
fevers may be summed up as follows : 





TYPHOID. 




TYPHUS. 


I. 


Forming stage from one to 


i. 


Forming stage from one to 




ten days. 




three days. 


2. 


Diarrhea. 


2. 


Constipation. 


3- 


Susceptibility to the action 


3- 


No tendency to diarrhea, or 




of purgatives. 




excessive purgation from 
purgatives. 


4- 


Countenance pale, or of a 


4- 


Countenance of a dusky 




reddish tint. 




hue. 


5- 


Abdomen tympanitic, with 


5- 


Abdomen flat ; and if there 




tenderness, and a gurg- 




is tenderness, it is gener- 




ling sound upon pressure 




al, and not confined to 




in the right iliac region. 




the right iliac. 


6. 


Coffee-ground stools. 


6. 


Dark, offensive stools, but 
not watery. 


7- 


Hemorrhage from the bow- 


7- 


Hemorrhage from the bow- 




els frequent. 




ewls seldom. 


3. 


Rose-colored eruption dis- 


8. 


Petechia of a livid hue and 




appears upon pressure. 




but little affected by pres- 


9- 


Ulceration of the ilium is a 




sure. 




( onstant pathological pe- 


9- 


No constant pathological 




culiarity. 




peculiarity. 



REMITTENT Fever. — This fever may sometimes baffle us 
in our diagnosis, unless we are on our guard. But if we re- 
member that periodical fevers come on abruptly, and with 
great severity, and that typhoid fever begins slowly, and grad- 
ually increases in severity, and is always accompanied with 
diarrhea, or a predisposition to it, we need not. have any 
doubts as to the character of the affection. And then again, 
there is a decided remission and exacerbation in remittent 
fevers sometime during the twenty-four hours ; whereas in 
typhoid the fever is continuous, except in that variety which 
we have designated as typho-malarial, in which there seems 



THEORY AND PRACTICE OF MEDICINE. IOI 

to be a blending of the symptoms of the two. But generally, 
if we have a correct knowledge of the clinical history and 
symptoms of these diseases, the careful observer need not 
make any mistake. 

Meningitis. — The symptoms of the typho-cerebral type 
of typhoid fever and meningitis may be mistaken for each 
other, unless the practitioner is familiar with the characteris- 
tics of the two affections. But the suddenness of the attack ; 
the flushed face ; the quick, full, and bounding pulse ; throb- 
bing of the carotid and temporal arteries ; the sharp pain in 
the head, with convulsive movements ; the injected eyes, and 
constipation of the bowels, all distinguish the latter from the 
former. 

Enteritis. — This disease may be distinguished from 
typhoid fever by remembering that in the former, the inflam- 
mation of the intestines is the primary disease, and precedes 
the fever, and the inflammatory action is more extensive over 
the abdomen ; the pain and tenderness are local, and confined 
to the ileo-caecal region ; and the bowels are loose from the 
beginning. In enteritis, there is but little prostration, until 
the disease has progressed for some time, or passed into the 
typhoid state. The spleen is normal ; and there is no mental 
wanderings, no rose-colored spots on the abdomen, nor suda- 
mena on the body ; while in typhoid fever the reverse is true. 

Gastritis. — Unless the physician is on his guard, a dan- 
gerous form of typhoid fever may escape his observation, or 
be obscured by gastric derangement, and the patient may be 
lost before he is aware of the nature of the malady. Func- 
tional derangements of the stomach are not accompanied with 
febrile excitement. But gastritis and typho-gastric are fol- 
lowed and preceded by fever. In the former the fever follows 
as a result of the inflammatory process set up in the stomach, 
pain and tenderness being the first symptoms manifest to the 



X02 THEORY AXD PRACTICE OF MEDICINE. 

patient ; and after a longer or shorter period, the fever is de- 
veloped. In the latter, the fever is the primary symptom, and 
the gastric disturbance is secondary. Nausea may be one of 
the earliest symptoms in the forming stage of typhoid fever ; 
but tenderness and excessive vomiting are not experienced 
until the fever and temperature begin to rise. Gastritis may 
generally be traced to some error in diet, or the act of 'swal- 
lowing' some irritating substances ; whereas, the history of the 
case, its gradual approach, with all the phenomena that ac- 
company continued fever, will point unerringly to typho- 
gastric. 

General debility simulates typhoid fever in its prostration 
of the organic functions, but the pathognomonic symptoms of 
the latter are wanting in the former ; and by gaining a cor- 
rect history of the case, and tracing the debility to its source, 
there need be no error committed in diagnosis. 

Typhoid Coxditiox. — It has ever been a source of annoy- 
ance to the young practitioner to trace the boundaries which 
separate typhoid fever from a typhoid condition. But if the 
distinction be firmly fixed in the mind that typhoid fever is a 
primary disease, and that a typhoid condition is a secondary 
morbid state, there need be no difficult}' on this point. A 
typhoid condition may supervene an attack of any disease ; 
therefore, our first duty is to trace the case to its origin, weigh 
ever}* symptom, and see whether the}- belong to a primary 
disease or a secondary state. If the clinical history and symp- 
toms of the case point to a primary disease, then what is the 
character of the affection, is it a general or a local trouble? 
This question can only be satisfactorily settled in proportion 
to our knowledge of the symptoms and peculiarity of those 
diseases, and our capability of weighing and sifting testi- 
mony. As we take our seat by the bedside of the patient, the 
question often arises whether it is a case of typhoid fever, 
or is it a typhoid condition ? If in tracing the history of the 
affection, we find the symptoms and peculiarities of the 



THEORY AND PRACTICE OF MEDICINE. I03 

former present, then we know that the case is one of typhoid 
fever. But if, on the other hand, the historical and most 
prominent symptoms are wanting, we infer that the morbid 
change is one of a typhoid condition, and is the result of 
some other malady, which must be diagnosed in accordance 
with the primary symptoms. 

Prognosis. — The prognosis of this disease is generally 
favorable ; a large majority of the cases recover with proper 
sanitary regulations. Yet it should be guarded ; for there 
is no case so favorable that may not disappoint us. In the 
midst of convalescence, when all symptoms point to a speedy- 
recovery, some untoward occurrence often takes place, and the 
patient sinks in a few hours. The unfavorable symptoms are 
an increased frequency and feebleness of the pulse, a coma- 
tose condition of the patient, involuntary discharges, subsul- 
tus, contraction of the muscles around the mouth and nose, 
picking at the bed-clothes or imaginary objects, slipping down 
in the bed, and a cold clammy sweat ; all point to a speedy 
dissolution of the patient. 

The indications of a favorable issue and a speedy conva- 
lescence are, a diminution in the frequency of the pulse, a 
gradual fall in the morning and evening temperature, the skin 
becomes cooler, consciousness returns, the tongue begins to 
clean from the tip and edges, the secretions return to their 
normal condition, the tympanitic abdomen begins to subside, 
and there is a returning relish for food. 

Treatment. — The treatment of typhoid fever has been, 
and is still, a subject of discussion. The four methods of 
treatment, or the therapeutics advocated by some of the older 
writers and physicians, and many of the present day, are 
venesection, brandy, emetics and cathartics. A moment's 
reflection will suffice to discard them all. And first, by bleed- 
ing, we draw off the very materials which we most need to 
sustain the patient, to build up the tissues, and to cam' him 
safely through the future progress of the disease. Further- 
more, it has been demonstrated that we cannot shorten the 



104 THEORY AND PRACTICE OF MEDICINE. 

progress of the disease by venesection, but rather prolong the 
cure. I do not deny that bleeding has done good in typhoid 
fever of the sthenic grade, by checking the flow of blood to 
the parts, and thereby preventing or arresting inflammatory 
action. But I should not like to risk the prostrating effects 
of venesection, when we have a sure anti-febrile agent in the 
veratrum viride and gelsemium ; and especially as they do 
not exhaust the elementary properties of the tissues as by 
bleeding. 

There are many persons who advocate strongly the use of 
brandy or alcoholic stimulants, so called, in typhoid and 
typhus fevers. But we have only to compare the pathological 
condition of the blood and vital forces in those diseases, and 
the physiological effects of alcohol, to show the impropriety 
of its use in those fevers. Experimenters are agreed that the 
blood, in typhoid and typhus fevers, is imperfectly decarbon- 
ized ; the fibrin is impaired in its coagulability ; the functions 
of the nervous and muscular tissues are greatly depressed ; 
susceptibility is increased ; vital affinity is diminished ; and 
the plasticity of the blood in a measure destroyed. Alcohol, 
while in the human system, diminishes the decarbonization 
of the blood ; it retards the coagulability of the fibrin, pro- 
duces an anaesthetic or depressing effect on the nervous centers, 
and diminishes organic changes (Davis). The first or tempo- 
rary effect of alcohol on the system is that of an arterial 
excitant, and its secondary effect is that of a powerful sedative. 
All investigators agree that alcohol is not digested, when 
taken into the stomach, and cannot therefore act as food, but 
passes through the circulation, and is thrown out of the sys- 
tem as a foreign substance ; not, however, until after it has 
left its fearful inroads upon the tissues and organic functions. 
With this view of the subject, I discard almost entirely the 
use of alcoholic liquors in my practice, especially in low forms 
of disease ; and I have never yet found occasion to regret it. 
In a lecture of W. T. Gairdner, Professor in the University of 
Glasgow, he said that he did not object to the moderate use 



THEORY AND PRACTICE OK MEDICINE. 105 

of alcoholic liquors in certain stages of typhoid and typhus 
fevers. But he condemned its indiscriminate use in such 
strong terms, and backed his opinion with such powerful 
reasons, as to convince any one that it is not only contra- 
indicated, but that it is positively injurious in almost every 
stage. I quote from Braithwait, Part 51, Page 22. He said : 

"To give wine, whiskey, or beef tea, while withholding 
milk, is simply, in my opinion, to destroy your patient soon, 
because you are thereby superseding the natural appetite (or 
what remains of it) for a nourishing and wholesome diet, by 
a diet — if it can be so called — which so poisons the blood, and 
checks the secretions, and alters for the worse the whole tone 
of the nervous system, and of the digestion and assimilation. 
I believe that infinite mischief has been done in typhus fever, 
and in all fevers, by giving w T ine, and withholding or not 
giving milk." And further along he remarks: "You must 
absolutely make up your mind to feed your patient naturally, 
and not stimulate him." You must remember this is the lan- 
guage of an old school medical professor. 

Dr. Richardson, of L,ondon, England, experimented upon 
himself forty or fifty years ago, to demonstrate the effect of 
alcohol on the human system. He took an ounce of brandy, 
after taking his temperature and counting his pulse. He re- 
peated the dose every hour, and found that from the begin- 
ning his pulse arose from seventy-five beats per minute to 
one hundred, and his temperature fell from 98. 5 ° to 98 °. He 
continued the experiment until fully under the influence of 
the brandy, when he found his pulse running from 120 to 140 
per minute, and his temperature fell below 98 °. Thus show- 
ing that while his nervous system and arterial circulation 
were terribly excited, the organic functions were greatly de- 
pressed. Or, in other words, while he thought that he was 
being stimulated and exhilarated he was, to all intents and 
purposes, dying while under the influence of the brandy. 
That experiment demonstrated the fact that alcohol is an or- 
ganic depressent instead of a stimulant. 



106 THEORY AND PRACTICE OF MEDICINE. 

One of the most important items to be observed in the 
treatment of typhoid fever, is the proper regulation and pro- 
motion of the hygienic agents, viz. : air, aliment, excretions, 
sleep, cleanliness, and affections of the mind. Without pure 
air and a free ventilation, our best efforts in medication will 
prove abortive. In typhoid fever, the patient's apartment 
should be ventilated both night and day. It is not only nec- 
essary to have windows let down from the top, but a free 
draught of air should constantly be made to pass through the 
room, night and day, so as to carry out all the exhalations 
from the patient. It is not necessary that the draught should 
blow directly on the patient, nor is it always safe, except in 
warm weather; then the patient may not only lie in the 
draught, between two doors or windows, not only with impu- 
nity, but with benefit. But if the weather be damp or cold, it 
will be best to screen the patient from the direct influence of 
the air, and kindle a little fire in his chamber. 

Cleanliness is another important consideration in the 
treatment of typhoid fever. When the patient is feverish, 
and the skin is dry, his body should be sponged once a day, 
or oftener, with cold water, containing chlorate of potash ; and 
the linen of his person and bedding should be changed every 
day. The chlorate of potash in the water acts as a disinfect- 
ant to the exhalations and thus acts as an antidote to the 
aplastic condition of the patient. The excrements should be 
immediately removed from the room and the apartments puri- 
fied, in addition to free ventilation, by some antiseptic. In 
a word, the patient's bed chamber should, if possible, smell 
as fresh and pleasant as a drawing-room. Only in this way 
can we hope for a quick and favorable action of our medi- 
cines, and a speedy convalescence of our patient. 

The diet of a patient with typhoid fever is a subject of 
the highest importance, both in its character, mode of prep- 
aration, and its use. It must be nutritious, small in quantity, 
and unirritating in quality. In all the varieties of this dis- 
ease, the milk porridge is the best diet that can be given. It 



THEORY AND PRACTICE OF MEDICINE. IO7 

is nutritious, pleasant, and agreeable to the stomach. Pure 
fresh milk, free from still-house and brewery swill, may be al- 
ternated with the milk porridge. Rice boiled in milk is pal- 
atable and easy of digestion ; but when we require an organic 
stimulant as well as nourishment, there is nothing equal to 
beef-essence well salted. We get a large amount of nutri- 
ment in a small bulk of material. Leibig, Armour, and 
Idyll's, beef extracts are very convenient preparations. As 
convalescence progresses, soft boiled eggs may be allowed in 
moderation, but the patient's return to solid food must be 
gradual, and with great care. Many convalescent typhoid 
patients have been sacrificed by indulging in solid food. 
Malted milk is an excellent diet for a convalescent patient. 

The excretions, sleep, and affections of the mind, which 
are under the control of physiological laws and the will, and 
which are so conducive to health, are so morbidly affected in 
this disease, that the patient loses his power of regulating 
them ; and the secretory, excretory, and nerve functions are so 
perverted, that remedial agents are necessary to assist nature 
in restoring the organs to their normal action. 

The indications for treatment in this disease : 1. To lessen 
febrile excitement and allay morbid heat. 2. Promote the ex- 
cretions. 3. Antidote or neutralize the fever poison, and elimi- 
nate the effete matter from the system. 4. Overcome morbid 
susceptibility and irritability. 5. Arrest and heal local lesion. 
6. Increase the vital affinity and tonicity of the system. 

Treatment of Simple Typhoid. — When we give the 
treatment for simple typhoid fever you must remember that it 
embraces the uncomplicated cases. In the first stages baptisia 
tinctoria is the first remedy to be given. It is almost the uni- 
versal opinion of observing physicians that baptisia will mode- 
rate the course of all cases of typhoid fever, and cut many 
cases short in from seven to fourteen days. The principal in- 
dications for the use of this remedy is a dark red and besotted 
expression of face. The patient is restless, tossing from side 
to side. The body seems to be scattered around and the patient 



108 THEORY AND PRACTICE OF MEDICINE. 

is trying to gather up the pieces. The excretions are fetid. 
The indications for arsenicum in this form of typhoid is a 
cadaverous, yellowish, or leaden color of the face. The tongue 
and lips are dark and dry. Intense thirst, drinking often, but 
little at a time ; patient is restless and fears death. Diagnosis 
between arsenicum and rhus tox. Rhus tox patient tosses from 
side to side, while an arsenicum patient only moves the limbs. 
Bryonia is indicated in simple typhoid fever where the tongue 
is covered with a dirty white, or yellowish fur. Intense thirst 
for large quantities of water at long intervals. The patient 
wants to keep quiet, as he is worse when moving. That is a 
grand characteristic of bryonia in all diseases. In some forms 
of typhoid fever the bowels are constipated in the early stages ; 
the stools are dry and hard. In this condition bryonia is in- 
dicated. Rhus tox — tongue dry, red and smooth, or red at tip 
in shape of triangle. Severe pains in limbs, worse during rest. 

Treatment OF Typho-EnTERIC. — The treatment of 
this variety must be conducted upon the same general princi- 
ples as that of simple typhoid fever, for the former is only a 
higher grade of the latter, or it has a more local character. 
Indeed, this represents the true enteric or typhoid fever. 
Therefore, our especial attention must be directed to the 
pathological condition of that portion of the ilium occupied 
by Peyer's patches. Our first effort should be to check the 
bowels, and thus prevent or check ulceration of the intes- 
tines, and thereby prevent death by perforation. In order to 
accomplish this, we must arrest the morbid secretion and ac- 
tion of the bowels ; for the constant passing of acrid secretions 
over the inflamed mucous membrane of the intestines, in- 
creases the inflammation, and hastens ulceration and death 
unless speedily relieved. In this condition we must call to 
our aid arsenicum which is indicated by dark green mucous 
stools, or dark, black watery stools, very offensive ; cutting 
pain in the bowels, with tenesmus. Sudden and rapid pros- 
tration. 

In addition to the symptoms calling for rhus tox to which 






THEORY AND PRACTICE OF MEDICINE. I09 

I have already referred, it is called for when the stools be- 
come thin, yellow and slimy. 

Ipecac, is demanded where there is nausea, with grass- 
green stools ; or when dysenteric stools supervene. 

Veratrum album is indicated where there is involuntary 
blackish watery stools, with cold sweat on the forehead. 

In this form of typhoid fever there is often a profuse and 
dangerous hemorrhage from the bowels, which, if not speedily 
arrested, may prove fatal in a few hours. 

Nitric acid, car bo veg n ipecac, and terebinthina are the most 
reliable remedies in hemorrhage from the bowels in typhoid 
fever. 

Nitric acid is called for when the discharges are involun- 
tary of black decomposed blood of a cadaverous smell. 

Carbo veg. is indicated where the stools are composed of 
foul blood and mucus of a cadaverous smell, usually in the last 
stage of the disease. 

Ipecac, is called for when there is nausea with bloody stools 
and cutting burning at the anus. 

Terebinthina is indicated for hemorrhages from the bowels, 
with ulceration. 

Treatment of Typho-Cerebral. — The treatment of 
typhoid fever of the cerebral type must be conducted on the 
same general plan that has been already indicated. But our 
attention must be early directed to the delirium or head symp- 
toms ; for without sleep the patient will die, and that speedily. 

Apis is indicated where the patient is unconscious, with 
muttering delirium, an eruption on the chest and abdomen, 
sliding down in the bed. 

Baptisia is indicated in the first stage of this complication 
on account of fever and head symptoms. The stupefying 
headache with confusion of ideas are prominent indications for 
the use of baptisia. 

Belladonna, as a rule, is the first remedy to be thought of 
in this complication. Especially when the face is flushed 
and bloated, with red, sparkling eyes, and dilated pupils. 



IIO THEORY AND PRACTICE OF MEDICINE. 

Throbbing headache, with violent pulsations of the carotids. 
Intolerance of noise or light. Delirium, with a wild look ; 
he wishes to strike, bite, or quarrel. Starting, jumping dur- 
ing sleep, with desire to escape. Sleepiness, but cannot sleep. 

Bryonia is indicated for a red, burning, swollen face. Op- 
pressive, stupefying headache, or pain as if the head would 
split, worse from the least motion. Delirium day and night, 
with strange fancies, and desire to escape from bed and go 
home. Cannot sit up from nausea and faintness. 

Hyoscyamus has brown-red, swollen face. Tongue red, 
brown, dry, and cracked. Lips look like scorched leather. 
Furious delirium, which continues while awake. Loss of 
speech and consciousness, fluttering, with picking at the 
bed-clothes. Great restlessness, jumping out of bed, and en- 
deavoring to escape. Eyes red and sparkling, staring, rolling 
about in their orbits. Twitching and jerking of the limbs ; 
subsultus tendinum. Paralysis of sphincter ani and vesical. 

Opium. — This remedy is indicated by a swollen and pur- 
plish color of the face ; extreme drowsiness and coma, with 
stertorous breathing ; delirious talking, with eyes wide open ; 
pulse full and labored, or slow and frequent ; impending par- 
alysis of the brain ; involuntary stools, and retention of urine. 
Never give less than 30X. 

Strammonium. — As the head symptoms of typhoid fever 
are usually arrested by some one of the remedies already 
mentioned, I will only refer to one grand characteristic of 
strammonium to-wit : jerking of the head up from the pillow, 
and letting it drop back. 

Zincum. — This remedy is indicated where there is entire 
loss of consciousness ; does not recognize his relations ; delir- 
ium, with staring eyes and efforts to get out of bed ; position 
on the back, and sliding down in the bed ; subsultus tendi- 
num, grasping at flocks, and feeling around as if searching 
for something; constant trembling of the hands, and cold- 
ness of the extremities ; small intermittent pulse ; impending 
paralysis of the brain. 



THEORY AND PRACTICE OF MEDICINE. Ill 

Treatment of Typho-Gastric. — The treatment of 
this type or complication requires a good deal of judgment, 
both as to the selection and use of remedies. Our first object 
must be to quiet the gastric irritation. 

Apis produces an inability to talk or put out the tongue, 
which is cracked, ulcerated, or covered with vesicles. Dry- 
ness of the mouth and throat, with difficulty of swallowing ; 
great soreness in the pit of the stomach and abdomen ; con- 
stipation, or frequent, foul, bloody mucus and involuntary 
stools. Thus you see, when the cerebral, gastric, and enteric 
types invade the same patient, then apis becomes an import- 
ant homoeopathic remedy. 

You should become familiar with all of the remedies I 
have mentioned under each grade of typhoid fever, so as to 
be able to make a judicious selection of a remedy for each 
type. 

Arsenicum. — Constant licking of the lips, which are dark, 
dry, and cracked, with sordes on the teeth ; tongue dry, shriv- 
eled, bluish, or black, with inability to protrude it ; intense 
thirst, drinking often, but little at a time. 

Colchicum. — This remedy is called for when the lips, 
teeth, and tongue are covered with a thick brown coating. 
Region of the stomach extremely sensitive to pressure ; diar- 
rhea; stools whitish, watery, offensive, involuntary. Cold 
surface, tongue and breath ; mottled skin and bluish nails. 

Mercurius. — The region of the stomach and liver very 
sensitive and painful ; green-yellow stools. 

Phosphorus. — This is indicated where there is thirst for 
cold drinks, but the patient vomits them as soon as they get 
warm in the stomach. 

The diet, in this grade of typhoid, should only consist of 
a few spoonfuls of milk porridge or ice cream. If the stom- 
ach is very irritable, it would probably be better not to give 
anything by the mouth except the medicines ; and allow the 
patient to swallow small pieces of ice, if he is thirsty. It will 
be better to nourish the system by means of beef extracts. 



112 THEORY AND PRACTICE OF MEDICINE. 

One or two ounces of the solution may be thrown into the 
rectum, every four to six hours. 

A great deal of care is to be taken during convalescence ; 
for there are probably more relapses in this variety than any 
of the others. Therefore, the patient should be restricted to 
a nutritious but unirritating diet for a long time, until the 
digestive organs regain their tone. 

Treatment of Typhoid-Pneumonia. — The treatment 
of this complication differs only from that of simple typhoid, 
in our efforts to overcome the pathological condition of the 
lungs. 

I r eratrum viride is one of the first remedies to be thought 
of in this complication ; for it is beneficial for fever, and con- 
gestion of the lungs. If the cough and bloody sputa indicate 
phosphorus, then it must follow the veratrum viride. If the 
cough is hard and harassing, then you must think of bryonia. 
If the cough becomes loose and great rattling in the chest, and 
dyspnoea, without expectoration, then antimonium tctrtaricum 
will be your sheet-anchor. 

Treatment of Typho-Malarial Fever. — Typhoid 
fever of this type is sometimes a most difficult disease to treat, 
owing to the variable character of its symptoms. At one visit 
we find our patient sweating profusely, with symptoms point- 
ing to remittent fever ; when we examine the pulse, we find it 
often ranging from 120 to 140 per minute, and at our next 
visit we find all the indications of a continued fever. The 
diarrhea, tympanitic bowels, dry skin, and habitude of mind, is 
an evidence that a typhoid poison is at work in the system. 
So the conflict seems to be between the morbific agent of 
typhoid fever on the one hand, and marsh malaria on the 
other, as to which shall gain complete possession of the sys- 
tem. For this reason, the case is somewhat troublesome to 
manage. But all we have to do is to select the homoeopathic 
agent for the symptoms as they arise. We will have to vary 
our treatment between that of typhoid and remittent fevers. 
Arsenicum, gelsemium, and muriatic acid, act very beneficially 



THEORY AND PRACTICE OF MEDICINE. II3 

in this complication. When the eyes are yellow, or if the 
patient is vomiting a yellowish or greenish matter, then mer- 
curius and podophyllin are indicated. 

To relieve your mind of the complicated treatment to which 
I have referred, I may mention the fact that you rarely find 
all the symptoms mentioned in any one case, and, as a rule, 
only two or three of the remedies are ever indicated in a single 
case. In a majority of cases baptisia, arsenicum, bryonia and 
only rhus tox. are indicated. 

HULK FEVER. 

This is a continued fever, and is known by the term milk- 
sickness. It is so called because it is generally produced by 
drinking the milk of cows which are affected by a peculiar 
condition called the trembles. Hither the milk, butter, and 
cheese made from the milk, or the flesh of the animal, are 
capable of communicating the affection to the human species. 

It occurs only in the southwestern portions of the United 
States, and that only in isolated localities. 

Symptoms. — Iyike the other continued fevers, it is apt 
to come on slowly, with a feeling of indisposition, a general 
muscular weakness, and a torpid condition of the bowels, with 
an offensive breath from the beginning. Some patients are 
irritable and delirious, while others are listless and drowsy. 

After the premonitory symptoms have lasted for a longer 
or shorter period, the disease is fully ushered in by nausea and 
vomiting, which is extremely distressing. There is excessive 
thirst, and the matters vomited consist of an acid fluid of a 
greenish or brownish color, which assume the coffee-grounds 
character before the close of the disease. The bowels become 
so constipated that the feces in the rectum become hard and 
dry ; the abdomen has a hard contracted feel. There is but 
little fever at first, yet the skin is dry and slightly icteric from 
the beginning. The tongue, which at first is white, becomes 
of a yellowish or brownish cast as the disease reaches its 
height. 



114 THEORY AND PRACTICE OF MEDICINE. 

Dr. Wm. H. Byford, who once lived in a milk-fever district, 
and from whose lecture I obtained my knowledge of the dis- 
ease, describes the odor of the breath as being almost intoler- 
able. He compares it to that produced by the mixture of the 
fumes of chloroform and the breath of a mercurialized patient. 
He describes two varieties, the inflammatory and the conges- 
tive or malignant. The former is of the sthenic grade ; the 
pulse is frequent and full ; the skin is dry ; the patient com- 
plains of a great degree of tenderness and pain in the epigas- 
trium and abdomen. The bowels, instead of remaining con- 
stipated as at the beginning, become loose and tympanitic, and 
give all the evidence of enteritis. The patient often flexes his 
thighs to relieve the tension of the abdomen. The stools be- 
come tinged with blood and mucus, and are thin and watery ; 
the tongue becomes red and dry, and sordes gather around 
the teeth ; the respiration is quick and laborious, the pulse 
becomes weak and fluttering, the patient becomes comatose, 
and death often closes the scene in two or three days. 

The congestive or malignant variety is more speedily 
fatal ; death often occurs in twenty-four hours. This type of 
the disease differs from the former only in this, that the mor- 
bific agent, attacking an aplastic patient, concentrates its 
force on some of the vital organs, by which they are over- 
whelmed by all the symptoms of blood-poisoning, and the 
patient dies in the congestive stage. 

Causes. — As to the cause or causes of this disease I will 
say but little, for the views of medical men are still conflicting. 
But this much is settled, that animals, which feed on certain 
pastures in particular geological regions, are affected by a 
peculiar condition which causes a loss of appetite, the animals' 
eyes are red, and they wander through the pasture careless and 
indifferent to objects around them. They appear weak, and 
if caused to exert themselves often fall dead. But generally 
they linger for some time, begin to tremble, fall in convul- 
sions and die. As the symptoms are sometimes slow in 



THEORY AND PRACTICE OF MEDICINE. 115 

developing in the animal, the milk may be used for sometime 
before it is known that the animal is infected. 

Whatever may be the character of the morbific agent, 
whether it is organic or chemical, it undoubtedly enters the 
system as a zymotic agent, by which a change is produced in 
the fluids of the body, and a blood-poison is set in motion 
which is capable of producing a specific disease correspond- 
ing to the generic character of the virus. 

Diagnosis. — The incessant vomiting, obstinate consti- 
pation, the hardened condition of the abdomen, and muscular 
weakness are diagnostic symptoms of milk fever. 

Prognosis. — The prognosis is favorable or unfavorable 
in proportion to the plasticity or aplasticity of the patient, 
and the amount of the poison that has been taken into the 
system. Some seasons the cases are mild and all recover. 
The cases of an inflammatory character are quite dangerous ; 
while those of the malignant type are very fatal unless 
promptly treated. 

Treatment. — The first indication to be fulfilled in the 
treatment of milk fever is to allay the vomiting and open the 
bowels with an enema of warm water. This helps to elimi- 
nate the poison from the system. 

Aconite. — Vomiting of bile, of green masses, with bitter 
taste, anxiety, heat, and thirst. 

Argentum nitricum. — Vomiting of a brownish mass, mix- 
ed with coffee-ground-like flakes. 

Arsenicum. — Vomiting of a brown and black substance; 
intense thirst for small draughts of water ; tenderness in the 
stomach ; prostration. 

Baptisia. — This remedy is indicated for the offensive 
breath, and a typhoid condition of fever. 

Gelsemium is indicated for fever, and extreme muscular 
weakness. 

Ipecac. — Nausea and vomiting of grass-green substance. 
Mercurius cor., is an excellent remedy for soreness of the ab- 
domen, stools tinged with blood and mucus. 



Il6 THEORY AND PRACTICE OF MEDICINE. 

Opium.— Patient becomes drowsy and comatose. 
Rhus tox. — Tongue dry, patient restless, stools watery and 
of a reddish cast. 

Veratrum viride. — Fever, nausea and vomiting. 

TYPHUS FEVER. 

This is also called Petechial Fever, Putrid Fever, Camp 
Fever, Ship Fever, Jail Fever, Hospital Fever, or Nervous 
Fever. 

This disease is characterized by a malignant type of one of 
the continued forms of fever. Fortunately, it is rarely seen 
except in unhealthy and overcrowded cities, in camps of an 
army, and in crowded jails poorly ventilated. 

Symptoms. — The patient complains of indisposition 
from one to three days before the disease is developed. The 
rigors are extremely severe. The patient has a succession of 
slight rigors, is seized with a severe one, which is usually suc- 
ceeded by dry heat of the skin, thirst, quick pulse from ioo to 
1 30 or more. White, dry, often tremulous tongue, scanty and 
high-colored urine ; sometimes he vomits, has a heavy look or 
stupor, dull muttering delirium, prostration, and muscular 
pains ; toward evening irritability, restlessness, and delirium 
increases, and if sleep occurs it is disturbed by dreams, or sud- 
den starts. Dr. Buchanan in describing this disease says : 
" In an average attack the patient lies prostrate on his back, 
with a most weary and dull expression of face, his eyes 
heavy, and with some dusky flush spread uniformly over his 
cheeks. In the advanced stage of a severe attack, he lies with 
his eyes shut or half shut, moaning, and too prostrate to an- 
swer questions, to protrude his tongue, or to move himself in 
bed ; or the mouth is clenched, the tongue and hands tremble, 
and the muscles are twitching and half rigid. The dryness of 
the mouth, the sordes on the teeth and lips, the hot dry skin, 
and the deafness, are other symptoms which strike an obser- 
ver so immediately as to deserve to be included in the physiog- 



THEORY AND PRACTICE OF MEDICINE. 117 

nomy of the disease." Dr. Maclagen reports that the average 
maximum of recovered cases, registered by the thermometer, 
is 104.3 , the highest recorded 105.2 , the lowest 103 , 106.4 
to 109 ° having been observed in fatal cases. In ordinary 
cases, the highest temperature is gradually reached on the 
fourth or fifth evening; the decline is often gradual, com- 
mencing from the thirteenth to the seventeenth day. The 
rash of typhus fever resembles stains produced by mulberry 
juice, which disappear on pressure. 

Pathology. — As a general thing there is no pathologi- 
cal lesion of any of the organs. The aplasticity of the patient, 
and the virulence of the morbific agent, is so great as to over- 
whelm the nervous system and to produce death before lesion 
takes place. The intestines sometimes show a tendency to 
ulceration. 

Cause. — Any surroundings that will induce the aplastic 
diathesis is a predisposing cause of typhus fever. The excit- 
ing cause is due to a morbific agent or bacillus generated by a 
chemical change of animal effluvia where people are crowded 
in unhealthy localities, in jails, ships and camps. 

Diagnosis. — The history of the case, and the surround- 
ings of the patient, will help you in your diagnosis. If the 
patient was ailing from one to three days before the rigors and 
fever developed, then you know that the case is not typhoid 
fever, for that disease comes on more gradually. The patient 
is complaining from seven to ten days before he takes to his 
bed. In this disease there is diarrhea, or at least the bowels 
are not costive, and there is always tenderness and a gurgling 
sound in the right iliac fossa upon pressure, which is not the 
case in typhus fever. And then again the bowels are costive 
in the latter case, at least in the early stages. 

Prognosis — Favorable. An abatement of febrile heat 
and thirst ; a gentle, warm moisture diffused equally over the 
whole surface of the body, succeeded by increased fullness 
and strength, with diminished frequency of pulse ; the ab- 
sence of delirium and stupor ; the absence of extreme pros* 



Il8 THEORY AND PRACTICE OF MEDICINE. 

tration of strength ; the petechia or hemorrhage being of a 
florid red color. • 

Unfavorable. — Early, furious, and persistent delirium, 
with complete sleeplessness ; coma-vigil ; convulsions ; extreme 
contraction of the pupil ; involuntary twitching of the mus- 
cles of the face and arms. In the advanced stages of the 
disease, hemorrhages break out from different parts of the 
body ; blood is effused under the skin, forming petechia, ma- 
culae, and vibices. The abdomen grows swollen and tense, 
and the excretions become extremely offensive, and are pass- 
ed involuntarily ; the feces are black, the urine is passed in 
bed, or retained ; the features are changed and sharpened ; 
low muttering delirium takes the place of the excitement of 
the first stage, accompanied by subsultus tendinum and pick- 
ing of the bed-clothes ; there is great prostration of strength, 
difficult deglutition and respiration ; gangrenous aphthae ap- 
pear about the mouth and throat ; the pulse sinks and inter- 
mits ; the extremities grow cold, and covered with a viscid 
cold sweat ; hiccough ensues, and death soon follows. 

Treatment. — For the febrile symptoms we must look 
to aconite, baptisia, bryonia, and gelsemhtm. You will recol- 
lect that aconite is called for, where there is intense thirst for 
large draughts of water at short intervals, headache, throb- 
bing of carotids, soreness of the bowels, thickly-furred tongue, 
foul taste. 

Baptisia is indicated where the patient feels that his body 
is scattered around, and he is trying to gather up the pieces. 

Bryonia called for when the patient craves large draughts 
of water at long intervals ; he wants to remain perfectly 
quiet, and has a tired feeling. 

Gelseminm. — This is a valuable remedy in typhus fever, 
both for the fever and the nervous prostration. This agent 
like bryonia produces a tired prostrated feeling. 

Cerebral Symptoms. — In this complication Bella- 
donna hyosciamus, strammonium, terebinthina, and veratrum 
viride will fulfill the indications. 



THEORY AND PRACTICE OF MEDICINE. II9 

Belladonna. — The face is bright red, the eyes are staring- 
arid glistening ; the tongue is partially paralyzed, thirst is in- 
tense ; there is furious delirium, the patient picking at the 
bed-clothes. 

Hyoscia?nus. — This is an invaluable remedy in typhus 
fever where the head is painful, the tongue is dry, brown, and 
glazed, the teeth are covered with sordes ; delirium super- 
venes, and the patient desires to escape. 

Strammoninm. — Loquacious delirium, with desire to es- 
cape out of bed ; no desire for water, although the mouth is 
very dry ; blackish diarrhea, smelling like carrion. 

Terebinthina. — This remedy is called for when there is a 
tendency of the kidneys to produce uraemic poison of the 
brain. 

Veratrum viride, is not only a valuable agent in febrile 
symptoms ; but it is also indicated for cerebral symptoms, 
where there is headache, dimness of sight, nausea, weakness 
and restlessness, with drowsiness, throbbing of the temporal 
arteries, hard quick pulse. 

SLEEPLESSNESS, can generally be overcome by the use of 
coffea, belladonna, gelsemium. Stupor is best combated by 
opium, thirtieth potency. It is called for where the face is of 
a dark-red hue, hot and dry. The breathing is stertorous ; 
the pupils are contracted. 

Extreme prostration is overcome by muriatic acid, and 
arsenicum. If there are any pulmonary complications you 
must look to bryonia and phosphorus. 

Putrescence. — The odor of typhus patients is charac- 
teristic ; it is offensive, pungent, and ammoniacal. Nurses, 
familiar with typhus, are able to recognize it by this symp- 
tom alone, and they estimate the amount of danger by the 
badness of the smell. This condition is best overcome by 
the use of car bo veg., arsenicum, rhus tox, and baptisia. 

The patient should be sponged with cold or tepid water 
containing chlorate of potash. If the skin is hot and dry then 
cold water may be used ; but if the skin is dark and cool then 



120 THEORY AND PRACTICE OF MEDICINE. 

tepid water should be used. The diet, in this fever, must be 
the same as recommended for the aplastic diathesis. That is 
to say, it should be nourishing but unirritating, consisting of 
beef essence, soft eggs, and milk. If stimulants are required, 
china, beef extracts and stro?tg coffee are the best ; for they are 
organic stimulants. Dr. I. D. Johnson in his Therapeutic Key 
in speaking of stimulants in typhoid fever says : "Alcoholic 
stimulants should be totally discarded, as they only exhaust 
the vital forces, which they have no power to restore." 

RELAPSING FEVER or FAHINE FEVER. 

This disease belongs to the type of continued fevers. It is 
rather abrupt in its invasion. It takes its name from the fact 
of its lasting about a week, and then abruptly subsides with a 
copious perspiration. It again returns as abruptly from the 
fourth to the tenth day from the first attack. It has another 
intermission when it passes through the same stages. It does 
not occur very frequently ; but is quite common in some parts 
of Europe. 

I simply call your attention to this disease so that you may 
become familiar with all classes of disease whether you are ever 
called to treat them or not. The people expect you to know 
all that is knowable in medicine, and hence you must be pre- 
pared to answer all questions put to you. 

Symptoms. — The disease comes on suddenly, the rigors 
and headache are very severe. There are pains in the limbs 
resembling those of rheumatism. The pulse ranges from no 
to 140 per minute. The temperature 102 ° to 107 . The 
tongue at first is furred, moist and white, but later it becomes 
dry and brown. Nausea and vomiting of bile is of frequent 
occurrence. On the seventh day a profuse perspiration super- 
venes, which is called the crisis. The patient is apparently 
convalescing, and seems to be progressing rapidly for four or 
five days, when suddenly another attack supervenes, and runs 
the same course. This disease is apt to be complicated with 



THEORY AND PRACTICE OF MEDICINE. 121 

pneumonia, bronchitis, hemorrhages, ophthalmia, and ton- 
silitis. 

Causes. — The real cause of this disease is not known. 
It is said that famine will produce it. Bad ventilation, filth 
in crowded tenement houses are supposed to be sources of re- 
lapsing or famine fever ; in other words, apparently, the same 
conditions that induce typhus fever will cause relapsing fever. 
There is, however, a difference in the bacillus or morbific 
agent. It may be possible that while typhus fever may pre- 
vail at one time under the same local conditions, yet the atmos- 
pheric changes at other times may produce relapsing bacilli. 

Diagnosis. — The suddenness of the attack distinguishes 
it from typhoid and typhus fevers. The continued character 
of the fever is evidence that it has no relation to remittent 
fever. 

Prognosis. — The epidemic of 1870 in Liverpool and 
Glasgow proved very fatal. It is said that it does not occur 
in tropical climates. 

Treatment. — Aconite, bryonia and arsenicum are the 
indicated remedies for the different stages. Baptisia must be 
given if any typhoid symptoms supervene. 

The diet and nursing require the same attention as recom- 
mended in typhus fever. 

DIPHTHERIA. 

It has been known as cynanche maligna, cynanche gan- 
grenosa, putrid fever, and putrid sore throat. 

This is an idiopathic disease with a tendency to local in- 
flammation of the mucous membrane of the air passages — 
especially of the pharynx. It is not a new disease as some 
have supposed. But it has prevailed in some portions of the 
world for ages — earlier than B. C. 460. It makes its appear- 
ance as an epidemic in certain latitudes, and after prevailing 
for a longer or shorter time it abates, and only a few endemic 
cases may be seen for a year or two, when it may break out 



122 THEORY AND PRACTICE OF MEDICINE. 

again. Thus, it may alternate for three or six years and then 
disappear indefinitely. But generally, sporadic cases may be 
seen for years after the epidemic influence has disappeared. 
Indeed diphtheria has come to be a very common disease in 
certain portions of the United States. 

Symptoms. — The patient first complains of lassitude 
followed by soreness and stiffness of the fauces ; aching of the 
back and limbs ; and all those train of symptoms which pre- 
cede febrile excitement. If the fauces be examined at this 
stage, they will be found a little inflamed. But there is noth- 
ing to distinguish the case from one of ordinary sore throat. 
Soon, however, the patient complains of chills alternated by 
flashes of heat ; the head and back become painful ; the tonsils 
become enlarged and of a crimson hue ; the voice is thick and 
nasal ; the tongue is covered with a whitish coat ; the eyes are 
watery ; the pulse is quick and small ; and the glands about 
the neck are swollen. At this stage of the disease there is a 
white fibrinous exudation thrown out upon the mucous mem- 
brane of the tonsils and surrounding structures. It affects the 
nasal passages, trachea, and bronchial tubes. The diphthe- 
ritic inflammation and exudation often attack the larynx from 
the beginning. In this case the symptoms resemble those of 
pseudo-membranous croup. 

The primary symptoms of diphtheria continue from two 
to seven days, when the membranous exudation gradually 
separates and leaves superficial ulcers of the tonsils with an 
abundant flow of fetid saliva. The ulcerations heal in from 
three to seven days ; the flow of saliva becomes more natural ; 
the tongue begins to clean and becomes moist ; the fever 
abates ; the skin becomes soft ; and convalescence is estab- 
lished. This is the course and result of nine-tenths of the 
sporadic cases of diphtheria. But the epidemic form does not 
always pursue this mild course. The patient is often prostra- 
ted from the beginning of the febrile stage. The exudation 
spreads, or makes its appearance on all portions of the mucus 
membrane from the nares to the ramifications of the bronchi. 



THEORY AND PRACTICE OF MEDICINE. 12 3 

The tonsils and cervical glands continue to enlarge, and fre- 
quently become ulcerated and gangrenous. These ulcers dis- 
charge shreds of exudation and a muco-purulent matter. Res- 
piration is often difficult and rattling, owing to the swollen 
condition of the tonsils, and the exudation lining the air pas- 
sages. The patient becomes drowsy and tosses the extremi- 
ties from side to side ; and frequently becomes delirious. The 
urine is frequently loaded with albumen ; the pulse grows 
quick and feeble ; the breathing becomes more difficult ; the 
vital powers give way ; and death often takes place about the 
second week. In these cases death takes place by asthenia. 
If death takes place during the first week it is caused by apncea 
and is the result of layngeal complications. Death may take 
place suddenly by heart-clot. 

As to the cause of diphtheria but little is known. We 
know that an epidemic influence, or an electrical change, is 
the predisposing cause of this disease. But we are unac- 
quainted with the elements which compose that influence. If 
we reason from the result obtained in the treatment, and the 
effects of remedial agents upon this disease, we must infer 
that there is a zymotic agent introduced into the blood ; and 
by its presence induces zymosis in that fluid. This fermenta- 
tive process so alters the fluids of the body, as to produce an 
impairment of the elementary properties of the tissues ; and 
the system is so completely under this influence that the least 
exposure to the exciting cause induces that pathological 
change, on the mucous membrane of the air passages, known 
as diphtheria. Bacteriologists have discovered in the exuded 
membrane what is termed Klebs-Iyceffler bacillus. 

Pathology has fully demonstrated the fact that diphtheria 
is a general disease with a local manifestation. The diphthe- 
ritic exudation has been discovered upon ulcers of the leg 
before it made its appearance in the fauces. It has also been 
found lining the hearts of patients who died after the disease 
had been arrested in the throat by local means. 

The constant tendency of this disease is to diminish vital 



124 THEORY AND PRACTICE OP MEDICINE. 

affinity, and increase susceptibility, and thereby change the 
chemical and physiological relations existing between the 
elements of the solids and fluids of the body. And thus they 
are readily broken down and converted into sanies, pus, and 
whitish fibrinous shreds. This fibrinous material is thrown 
out upon the mucous membrane in patches, and is called 
diphtheritic exudation. 

Diagnosis. — The diagnosis of this disease is sometimes 
a little difficult in the early stage, before the exudation has 
made its appearance. But as it is not long in showing itself 
after the general symptoms have been developed, there is not 
much difficulty in diagnosing the case. Diphtheria may be 
distinguished from tonsilitis, in view of the fact that, in the 
former, the tonsils are not so much enlarged, in the early 
stage, as they are in the latter. And while in tonsilitis it is 
more painful to swallow a large morsel, in diphtheria the pa- 
tient complains more from swallowing a small one. And, 
then again, in tonsilitis, the lymphatic glands, in the parotid 
and submaxillary regions, are not enlarged, if ever, until the 
disease has progressed for some time ; while in diphtheria 
they are swollen from the beginning. If diphtheria manifests 
itself first in the larynx, it is sometimes difficult tc distin- 
guish it from ordinary croup. But if we remember that the 
latter is primarily a local trouble, and that the hoarseness 
and whispering voice precede the fever ; and that the lym- 
phatic glands about the neck, and the tonsils are generally 
free from enlargement and inflammation in the early stage, 
while the reverse is true of the former, there need not be 
much trouble in diagnosing. 

Ulcerated throat may be distinguished from diphtheria in 
view of the fact that the ulcers are in round spots on the 
tonsils, and generally there is but little odor. While in diph- 
theria the exudation covers the tonsils, pharynx and uvula in 
patches and the breath is very offensive. 

Prognosis. — The prognosis of diphtheria will be favor- 
able or unfavorable in accordance with the character of the 



THEORY AND PRACTICE OF MEDICINE. 1 25 

epidemic, or the sanitary condition of the place in which it 
occurs. During some epidemics, and in certain localities, this 
disease has proved to be a terrible scourge to the inhabitants 
— especially among children. But whether from the increas- 
ed knowledge of the pathology of the disease and the facility 
of its treatment, or the decline of its malignancy, the profes- 
sion can manage it much more satisfactorily latterly than 
they could formerly. But it must be remembered that dur- 
ing an epidemic there is no case, however mild in the begin- 
ning, that may not prove fatal. On the other hand, there 
are but few endemic cases that die if they are seen in time 
and are properly treated. The sources of danger are from 
laryngeal complications and exhaustion. If the respiration 
is laborious, and the pulse becomes very frequent and small, 
a speedy dissolution may be looked for. Constant vomiting 
is an unfavorable symptom ; and if albumen is abundant in 
the urine death is almost certain to follow sooner or later. 

The first indications of a favorable result are : the fever 
abates ; the skin becomes cool and moist ; the tongue begins 
to clean from the tip and edges ; the voice becomes more nat- 
ural ; and the patient sleeps more quietly, and when he 
awakes he feels refreshed. 

Sequelse. — The most dangerous sequelae that may come 
on during the early period of convalescence is an affection of 
the heart. It is frequently clogged with fibrinous exudation, 
and death may take place suddenly, from cessation of the 
heart's action. 

Erysipelas frequently follows in the train of an epidemic 
of diphtheria. As a general rule erysipelatous forms of in- 
flammation prevail in a neighborhood long after diphtheria 
has lost its epidemic character. Paralysis is of frequent oc- 
currence after an attack of diphtheria muscse volitantes and 
other affections of the eyes are also frequent sequelae. 

Treatment. — As a rule, the indication for treatment in 
the first stage of diphtheria is belladonna. It is indicated where 
the fauces and tonsils are of a bright red color, and very dry. 



126 THEORY AND PRACTICE OF MEDICINE. 

The patient is restless and drowsy, yet cannot sleep. He is 
nervous and starts in his sleep, or wants to leave the bed. 
There is more or less delirium or wandering of the mind. 

Biniodide of mercury is an invaluable agent in this dreaded 
disease. It is especially indicated where the throat is covered 
with a pseudo-membrane of a slightly pinkish tint. The 
tongue is heavily coated with a slightly pinkish fur. I wish 
to say that the 3X potency of this agent has almost been specific 
in simple ulceration of the tonsils of a slightly pink tint. 
Biniodide of mercury 2&A belladonna are about the only reme- 
dies needed for that condition of the throat. 

Cya?iide of mercury is called for where the exudation is a 
clear white and ptyalism is present. The exudation pervades 
the nares. The pulse becomes small, and rapid or intermittent. 

Apis follows this remedy where there is great debility from 
the beginning. The membrane is of a grayish color. The 
eyes are swollen, and the ears are painful when swallowing. 
The parts affected have a stinging sensation which resembles 
that of the sting of a bee. 

Arsenicum is indicated where there is intense thirst for 
cooling drinks, but the patient takes but a sip at a time. 
There is great prostration, and the discharges are fetid. 

Arum triphyllum has for its indications a raw sore throat ; 
the mouth emits a putrid odor. Burning, ichorous discharge 
from the nose, excoriating the nostrils and upper lip. The 
corners of the mouth are cracked. 

Bryonia. — This remedy has parched, dry, and cracked lips. 
He wants large draughts of water at long intervals. He cannot 
bear to move because it makes him feel worse, and if he at- 
tempts to raise up he turns sick and faint. 

Lachesis is indicated where the exudation first shows its 
appearance on the left side. The nose and mouth are excori- 
ated by a fetid discharge. The fauces covered with a diphthe- 
ritic membrane. Patient worse after sleeping. 

Phytolacca. — The phytolacca patient has a dark-colored 
membrane with excessive fetor. 



THEORY AND PRACTICE OF MEDICINE. 1 27 

Permanganate of potash. — For malignant diphtheria with 
a terrible offensive odor there is probably no agent that can 
surpass this remedy. It is also valuable as a spray or gargle 
to remove the offensive odor. A few grains of the crude mate- 
rial to a goblet of water may be used as a gargle, or as a spray 
from the atomizer, three times a day. But when you use the 
gargle you must not give any other medicine for an hour 
afterwards. 

When the diphtheritic membrane extends into the larynx 
then we have all of the symptoms of croup, which is termed 
diphtheritic. In that case we must resort to other agents whose 
specific action is in the larynx. To this class belong chloride 
of lime, bromine, kali bichromicum, and iodine. 

Dr. Neidhard recommends the solution of the chloride of 
lime in all conditions of diphtheria, but more especially for the 
laryngeal complication. I am sure that I have saved some 
patients with this remedy. I put about twenty drops of the 
solution in a goblet of water with a little sugar, and let the 
patient take a teaspoonful every hour until he begins to im- 
prove, then increase the interval between the doses to every two 
to four hours. In that strength you will produce an aggrava- 
tion by continuing to give it too long. 

Bromine is indicated where the disease first began in the 
larynx and then made its appearance in the fauces. The cough 
is a hoarse, suffocating, whistling sound. 

Iodine. — Hoarse croupy cough, with wheezing, sawing res- 
piration. 

Kali bichromicum has a hoarse, croupy cough, with expec- 
toration of stringy mucus. Tough, stringy discharge from the 
nose. 

There are other remedies that seem to be indicated in this 
disease, but those I have mentioned will help you through 
with a large majority of your cases if you study them well. . 

I may mention that lac caninum has been greatly extolled 
for diphtheria with white ulcers on the tonsils. Lachesis for 
left tonsil. 



128 THEORY AXD PRACTICE OF MEDICINE. 

Tracheotomy is recommended by some, but I never would 
advise it in diphthiretic croup, for if the exudation is extend- 
ing downwards it will pervade the lungs, and the patient 
will die in spite of an operation, and the operation may induce 
blood-poisoning. Intubation is now practiced to relieve the 
patient from the horrors of suffocation. 

The flour of sulphur blown on the fauces is an excellent 
local application ; it gives great relief to the patient, and is 
homoeopathic to the exudation. 

The patient's room should be maintained at a temperature 
of 68° F. He should constantly inhale warm vapor. The 
steam from a boiling tea-kettle ma}- be conveyed to the pa- 
tient's bed through rubber tubing. If necessary a tent may 
be made of blankets over the head of the patient, and the 
vapor conveyed under them. As a last resort, you may con- 
vey the vapor of slacking lime and iodine under the tent. A 
piece of unslacked lime and ten to thirty drops of the tinc- 
ture of iodine may be put into a tea-kettle of water and 
gradually heated until a vapor is produced and conveyed to 
the patient by tin or rubber tubes. You must remember that 
lime is a carbonate, and when it is slacking it gives off car- 
bonic gas, which is poisonous without an admixture of fresh 
air to supply the-oxygen to the lungs to counteract the delete- 
rious effects of the carbon. The iodine and the lime unite to 
form the iodine of lime, which .is a valuable agent for croup. 
It is supposed that the fumes from the lime has the power of 
dissolving the diphtheritic membrane. 

Ice is very grateful to the patient in the febrile stage. He 
may be allowed to suck bits of crushed ice. It both quenches 
thirst and assists in allaying local inflammation. When the 
skin is hot and dry, bowels costive, and urine scant, warm 
baths are very beneficial to assist nature in throwing off the 
poison. 

Pine-apple juice 'is homoeopathic to the diphtheritic exuda- 
tion. That is to say the unripe fruit is capable of producing 
a sore throat similar to the first stages of diphtheria. The 



THEORY AND PRACTICE OF MEDICINE. 1 29 

natives of the islands use but little else than the juice of the 
ripe pine-apple for diphtheria. I have seen good results from 
its use. 

Diet. — The patient must be nourished from the begin- 
ning. Beef essence, milk porridge, and eggs beaten up in 
milk are the most suitable diet for a diphtheritic patient. You 
will notice that the diet I have recommended is the most suit- 
able to overcome the aplastic diathesis, as well as to nourish 
and stimulate the patient. 

If the stomach should be irritable, or any difficulty in swal- 
lowing, then an ounce or two of the essence may be thrown 
into the rectum, with a syringe, three or four times a day. If 
the patient require any other stimulants than the beef essence, 
then you can give strong coffee and unfermented grape juice. 
They arouse the organic functions and thereby promote the 
circulation ; and give tone to the whole system. There is 
quite a contrast between the effects of alcoholic stimulants, 
grape juice, coffee, and beef essence on the system. Alcohol 
acts as an arterial excitant, but depresses the organic functions. 
While, as we have already seen, grape juice, beef essence and 
coffee, stimulate the organic functions, and thereby promote 
the circulation ; that is to say, the pulse becomes full and more 
regular. This being true then it is detrimental to the patient 
to give any form of alcoholic stimulants in diphtheria. It is 
true that many physicians prescribe them, but I dare not use 
them after a careful study of their physiological and toxico- 
haemic effects. 

I may remark that there are many brands of beef extracts 
on the market which are very fine, but many patients prefer 
the home-made. 

Antitoxine, a supposed preventive and cure for diphtheria, 
is now being discussed pro and con by the profession. While 
there are many reports favorable for its use, yet there are 
some adverse reports, and some deaths claimed by its use. So 
upon the whole, I am inclined to await further developments 
before I can advise you to use it. It is to be hoped that it 

9 



130 THEORY AND PRACTICE OF MEDICINE. 

may, in the near future, be shown to be a valuable discovery 
in diphtheria. But until further developments, I advise you 
to rely on homoeopathy. 

Prophylactics — lachesis for diphtheria, belladonna for scar- 
let fever, and Pulsatilla for whooping cough. 

PERIODICAL FEVERS. 

These fevers are characterized by regular periods of ex- 
acerbations which establish the forms of their periodicity. 
Their effect as a class on the system, is to check secretion, 
nutrition, and calorification ; and consequently destroy vital 
affinity, and increase susceptibility. 

These fevers are classified as follows : 

f Simple Intermittent, 
Intermittent. X Inflammatory Intermittent, 
Pernicious Intermittent. 



Periodical Fevers. X 



f Simple Remittent, 
Remittent. X Inflammatory Remittent, 
Pernicious Remittent. 



Yellow Fever. 



INTERMITTENT FEVER or AGUE. 

This is an idiopathic disease, and, as its name implies, is 
characterized by regular paroxysms of fever preceded by a 
cold shivering sensation. From the end of one paroxysm to 
the commencement of the next constitutes the apyrexia or 
intermission. And the period occupied by a paroxysm and 
the succeeding apyrexia is called the interval There are 
many types of this fever, but for all practical purposes they 
may be classified under three heads — the quotidian, tertian, 
and quartan — that is to say, we may have a paroxysm every 
day, every other day, and every third day. Or to make it 
plainer, we may state that in the quotidian we have a paroxysm 
every twenty-four hours. 



THEORY AND PRACTICE OF MEDICINE. I3I 

In the tertian, as the name implies, we have a second 
paroxysm the third day, including the one in which the first 
paroxysm occurred ; or it is forty-eight hours from the begin- 
ning of one paroxysm to the beginning of the next. 

In the quartan we have a paroxysm every four days, includ- 
ing the One in which the first occurred ; or it is the third day 
from the one in which the paroxysm occurred first. Or to 
make it still plainer we may say that the quotidian occurs 
every twenty-four hours ; the tertian every forty-eight hours ; 
and the quartan every seventy-two hours. These three forms 
of intermittents may vary ; we may have a double quotidian — 
that is to say, two paroxysms within the twenty-four hours ; 
we may have a double tertian with two paroxysms within 
forty-eight hours ; and a double quartan with two paroxysms 
within seventy-two hours. And we may have a triple tertian 
and quartan. But whatever may be the type, the regularity 
of their periodicity is the same. The quotidian type generally 
occurs in the morning ; the tertian about noon ; and the quar- 
tan some time in the afternoon. 

Symptoms. — If the plasticity of the system be impaired 
and the exciting cause vigorous, the patient may be taken sud- 
denly in the midst of apparent health, and brought under the 
control of the morbific agent without warning. But generally 
the patient has a feeling of indisposition for some time pre- 
vious to the development of the pathognomonic symptoms. 
Whatever may be the mode of attack, there are three well 
marked stages in the progress of the paroxysm. These are 
called the cold, the hot, and the sweating stages. They usually 
succeed each other in regular order, and at stated periods. 

Cold Stage. — In the cold stage the patient first com- 
plains of a tired feeling ; and he has frequent yawnings with 
a desire to extend the extremities. These symptoms are soon 
followed by aching and chilliness of the limbs. The patient 
complains of an icy coldness which pervades the whole body, 
and throws him into a convulsive or shivering motion. He 
is unable to control his muscles ; his teeth chatter ; his body 



I32 THEORY AXD PRACTICE OF MEDICINE. 

feels cold, and the rigors are so severe as often to cause trie 
furniture and glassware of the room to rattle. The features 
are changed, the nails and fingers turn blue ; the skin as- 
sumes a rough purplish appearance denominated the goose- 
skin. Nausea and vomiting are often present. 

The cold stage lasts from half an hour to two hours and a 
half, and then gives place to the 

Hot Stage. — The skin begins to feel warm, and as the 
temperature rises it becomes flushed. The whole body be- 
comes hot ; and the thermometer shows a temperature rang- 
ing from 105 ° to 106 F. The face looks swollen; the 
carotids bound ; the pulse is frequent and full ; the patient 
often complains of violent headache, and delirium is often 
present. The tongue is covered with a thick whitish fur ; 
the thirst is great, and there is a loss of appetite The fever 
lasts from three to eight hours, when the third, or sweating 
stage, begins to be developed. 

Sweating Stage. — This stage is ushered in by a mild 
perspiration which first shows itself on the face near the hair. 
It gradually extends until the whole body becomes bathed 
with a copious perspiration. The linen and bedding of the 
patient are saturated ; and the skin looks shriveled as a wash- 
woman's hands. The patient looks pale and feeble. But 
when the sweating has subsided, and the linen has been 
changed, and the patient has taken some nourishment, he 
feels revived ; and is often able to resume his avocation as 
usual, until a return of the paroxysm, when he passes through 
all of the stages and symptoms as before. But generally 
the patient feels badly during the remission ; the tongue is 
furred ; the appetite is impaired, and the muscles of the body 
feel sore. The paroxysms recur at the same hour of the day, 
and often continue to do so for weeks or months, unless their 
periodicity is interrupted by treatment. Sometimes there is 
an effort of nature to throw off the morbific agent ; and by 
this effort the periodicity of the disease is changed in its time 
of occurrence. It frequently occurs an hour earlier, or an 



THEORY AND PRACTICE OF MEDICINE. I33 

hour or so later. Sometimes the paroxysm skips over the 
day, and comes on during the night. But whatever time it 
appears, it retains its peculiar characteristics. It frequently 
happens that the cold stage is so slight as to escape the notice 
of the patient. The fever appears to come on without the 
chill or cold stage. But upon a close examination we will 
find that the tip of the nose, and ears, or ends of the fingers 
are cold before the fever comes on. Drainage has done much 
to change the type of intermittent fever. Periodical neural- 
gia and other diseases have assumed the periodicity of inter- 
mittent fever without having its regular paroxysms. 

By whatever means a paroxysm is checked, it has a tend- 
ency to return unless the materias morbi is removed from the 
system. The periods at which it is most likely to return, are 
the seventh, fourteenth, and twenty-first days after the par- 
oxysm has been checked. If a patient passes three weeks 
without a paroxysm it will not be likely to return during that 
season. Simple intermittent fever is easily controlled by 
proper treatment, and it leaves no unpleasant results. It is 
only when the disease is neglected, or when it assumes an in- 
flammatory type, that the system is left in a morbid condition. 

Inflammatory Intermittent. — This differs from the 
simple variety only in degree ; and it is characterized by a 
higher grade of arterial excitement, a hotter and drier skin ; 
and the fever lasts somewhat longer. And when the inter- 
mission does occur the patient does not feel so free from the 
effects of the disease as he does in the simple variety. 

Although this sthenic grade of intermittent fever is called 
inflammatory, there is not always inflammation present in each 
case. There may be only an accumulated excitability of the 
properties of the tissues which gives to the disease its sthenic 
character. But, generally, there is more or less inflammation 
of some of the viscera. The spleen, stomach, liver and kid- 
neys are the most frequent seats of irritative or inflammatory 
action in this disease. 



134 THEORY AND PRACTICE OF MEDICINE. 

The inflammatory intermittent may be a sequel of the 
simple, or it may be primary — that is to say, the miasma may 
localize itself and produce an irritation or inflammation by 
zymosis or otherwise at the time or soon after the general 
manifestations of the disease have been developed. Or the 
idiopathic fever having been fully formed ; it expends its force 
upon the nervous centers and thus the most susceptible part 
of the organism is morbidly affected. 

If the spleen becomes inflamed, there will be pain and ten- 
derness in the left hypochondriac region under the margin of 
the ribs. If the liver be the seat of inflammation, the pain 
and tenderness will be felt in the right hypochondrium. The 
skin and conjunctiva of the eye will have an icteric hue. But 
if the disease be expending its forces upon the stomach, the 
pain and tenderness will be felt in the epigastric region, with 
nausea and vomiting. The region of the kidneys are often 
found to be tender, the urine scanty and reddish or yellow. 

In all of these complications the fever is higher and lasts 
longer, than it does in the simple variety, and the tenderness 
continues throughout the paroxysm and the intermission ; and 
it only subsides with the arrest of the paroxysm and removal 
of the cause. 

We come now to speak of another variety of intermittents, 
and one which is often speedily fatal. This we denominate 

Pernicious Intermittent. — There are three modes by 
which the morbific cause of this disease manifests itself upon 
the system : ist. The comatose ; 2nd. The algid ; 3rd. The 
typhoid. 

In the first variety, after a slight chill, the patient falls 
into a comatose condition out of which he cannot be aroused 
for six or eight hours — if ever. The force of the disease is 
expended directly upon the cerebral functions ; and death 
takes place by coma. This form may be mistaken for simple 
congestion of the brain. 

In the second, or algid variety, the disease comes on as a 



THEORY AND PRACTICE OF MEDICINE. 1 35 

simple intermittent. But when we suppose that the patient is 
going- into the cold stage, he will chill a very little ; and sud- 
denly the system will relax, and an icy coldness come on, and 
pervade the whole system except a small space around the 
heart. In this form of pernicious fever, the malarial poison 
acts directly upon the organic functions through the circula- 
tion ; and so affects the vital affinity of the system that death 
is often produced in from two to eight hours. If the patient 
rallies soon after the first attack, and means be speedily em- 
ployed, he can be cured. But if nothing be done until the 
second paroxysm comes on, he will be likely to die. Yet if 
our treatment is energetic, and we persevere in our efforts, the 
patient may rally. But if he is attacked the third time there 
is scarcely any hope, 

In the third variety of pernicious intermittent, which we 
have denominated pernicious typhoid, the patient, after hav- 
ing a slight chill, is suddenly seized with diarrhea, vomiting, 
and cramping, which soon prostrate the powers of life ; or in- 
duce a low typhoid condition. This form of pernicious inter- 
mittent is frequently mistaken for cholera. 

It is an interesting subject to inquire into the action of 
malarial poison on the system in pernicious fevers, and see 
how its fearful results are produced. Some believe that it so 
acts upon the animal economy as to cause congestion of the 
lungs, brain, stomach, and bowels — hence the name, conges- 
tive chill. But post mortems do not always reveal evidences 
of congestion sufficient to account for death. There may be 
engorgement of the capillaries of the organs ; but it is not that 
form of congestion which precedes inflammation. That en- 
gorgement is due to enervation and a want of contractile power 
of the tissues, by which the blood is forced from the organs, 
and propelled through the circulatory apparatus. That loss 
of tonicity or contractile power of the capillary system and of 
the muscles, is due to the powerful impression which the 
blood-poison makes, either directly upon the organic tissues 
through the circulation, or indirectly through the nervous 



136 THEORY AND PRACTICE OE MEDICINE. 

centers. And thus anaesthesia is produced, the vital powers 
give way, and the patient dies either of a failure of the animal 
or of the organie functions. 

Causes. — Intermittent fever is supposed to be caused 
by inhaling emanations from vegetable decomposition in 
marshy districts ; and by drinking waters which contain veg- 
etable matter. These two propositions have been fully dem- 
onstrated on the prairies of the West. I have known whole 
families, who were living on the high and rolling prairies, 
prostrated by the chills. On those prairies the inhabitants 
have to dig from fifty to ninety feet for water, which when 
found is perfectly pure and free from surface water. But 
these prairies are interspersed with sloughs or marshes which, 
during the hot summer months, give off their malarial poison. 
This poison must undoubtedly enter the system by inhala- 
tion, since there is no other reasonable explanation that can 
be given of its introduction into the blood in those particular 
localities to which I have referred. 

And then again, we have evidence that the malarial poison 
has been communicated to the blood through waters taken 
into the stomach. In proof cf this fact, it has been noticed 
that families in Chicago, who used well water, were regularly 
attacked by intermittent fever at each recurring season ; while 
their neighbors, who were supplied with pure hydrant water 
from Lake Michigan, were exempt. We account for that dif- 
ference in this way. Chicago is located on a flat marshy soil. 
In some portions of the city water is found by digging from 
six to twelve feet ; and the land is so level that during the 
fall and spring rains, the earth becomes saturated and the 
water seeps through the loam into the wells and carries the 
decaying vegetable matter with it. 

It is well known that intermittent fever does not prevail, 
only to, a very limited extent, in the populous portions of 
cities, where the inhabitants are supplied with pure water ; 
and, therefore, we can account for its occurrence only in ten- 



THEORY AND PRACTICE OF MEDICINE. 1 37 

ement houses in view of the fact that the poor are unable to 
purchase pure hydrant water, and are therefore compelled to 
use that from wells containing surface water. For further 
proof of the fact that miasmata may be taken into the system 
through the water that is used for drinking purposes, a case 
is related of a company of soldiers who were stationed in the 
mountains of New York. During the summer nearly the 
whole of the company were attacked with intermittent fever. 
As it was rare, if ever, to see a case of malarial fever in that 
region, the question was naturally asked what produced the 
disease among the soldiers? An investigation was set on 
foot to find the cause. It was ascertained that the soldiers 
were using water for drinking, cooking and bathing purposes, 
from a rivulet that came from the hills or mountains. Upon 
tracing this to its source, it was found that the water came 
from a pond containing weeds, grass and leaves in a state of 
decomposition. 

The soldiers being removed, or provided with pure water, 
they were soon restored to health, and were not troubled 
again with chills and fever. This circumstance proved that 
while vegetable decomposition was going on in the little pond, 
there was not enough to impregnate the air with the paludal 
poison. But the water, passing from that little laboratory of 
vegetable zymotics, held in suspension miasmata ; and thus 
it was conveyed to the stomachs of the soldiery, where a lit- 
tle leaven leavened the whole lump. 

I believe that the opinion is now almost universal among 
the profession, that marsh miasmata is the cause of that class 
of fevers called malarious or periodical. But the nature of 
the morbific agent is not well understood. There are two 
theories in regard to its character. One party believe that it 
is an animalcule called bacillus, while the other is of the 
opinion that it is a vegetable organic or zymotic product. I 
am inclined to believe that the latter is correct ; and that when 
the agent enters the system, and comes in contact with some 
of the organic elements of the body, decomposition begins to 



138 THEORY AXD PRACTICE OF MEDICINE. 

take place, and a fermentative process is set up, by which the 
whole system is brought under its influence ; and the nervous 
centers are so affected as to produce a change in the organic 
functions through w T hich the characteristics of the disease are 
manifested. It is true the vegetable zymotic product may be 
a bacillus. 

It is a well known fact that moisture, heat, and vegetable 
decomposition are essential to the propagation and evolution 
of malarial poison. If either are wanting, we can have no 
marsh malaria. We may have vegetable decomposition and 
a high temperature ; but we cannot have a cause sufficient to 
produce malarial fevers without a certain amount of moisture. 
And these three elements must be united in certain localities, 
or geographical districts, to produce the agent under consider- 
ation. That is to say, the soil must be of that character, that 
will retain the falling rains for a certain period ; in order to 
give time for the heat of the sun to produce a chemical change 
in the water, and the decaying vegetable matter, by which an 
organic element is evolved, and set afloat in the atmosphere 
to be wafted into the dwellings and lungs of the inhabitants ; 
or be conveyed into the waters, which are used for drinking 
purposes. 

Malarial fevers are known to be more prevalent in marshy 
districts where the crust of the earth is loam}' and underlaid 
with strata of clay sufficient to hold water for a considerable 
length of time. The overflowing of level countries, or the fill- 
ing of sloughs and ponds with water containing vegetable 
matter, and which are left to evaporate under the influence of 
a hot sun, are prolific sources of periodical disease. In the 
early settlement of the western and south-western states, 
as the prairies were broken up, and the sod was undergoing 
decomposition under the influence of early rains and a hot 
summer, nearly all of the inhabitants were prostrated with in- 
termittent and remittent fevers, as often as the summer and 
autumnal months returned. But so soon as the country was 
settled up. and the lands were broken or tilled, and the sloughs 



THEORY AND PRACTICE OF MEDICINE. 1 39 

were drained, chills and fever were of rare occurrence. I have 
frequently noticed that when the prairies have been settled, 
and the virgin soil thoroughly tilled, and the sloughs were 
drained, so as to retain no surface water, there was not a suffi- 
cient amount of miasma generated to produce intermittent 
fevers ; but in their stead, periodical neuralgia prevailed. It 
has been noticed that when the sloughs and ponds were filled 
with water during the summer and fall, chills and fever were 
not so prevalent. But if these sloughs and ponds were drained, 
or dried up by evaporation before cold weather came on, in- 
termittent fever prevailed until the winter was far advanced. 
This fact led to the doctrine, that ponds, in malarial districts, 
should never be drained only in cold weather. Because so 
long as decaying vegetable matter is covered by a large body 
of water it cannot be evaporated, and therefore remains pow- 
erless for evil. 

Diagnosis. — The diagnosis of intermittent fever is gen- 
erally easy. But as we shall see hereafter it is not always easy 
to tell whether certain pathological changes are due to mala- 
ria or not. The diseases most likely to give us trouble in 
diagnosis, are remittent and hectic fevers. The chill is shorter 
and not so severe in remittent as it is in intermittent ; and the 
fever lasts longer in the former than in the latter — that is to 
say the fever in remittents last nearly twenty-four hours before 
there is a remission ; and even then the patient is not free 
from fever, it is only an abatement of its severity. But in 
intermittents the patient is entirely free from fever between 
the paroxysms. 

Hectic fever may be distinguished from intermittent by 
its history. For it is almost always the result of some con- 
stitutional trouble of long standing. And then again, the 
fever and perspiration do not observe that degree of regular- 
ity or periodicity that is observed in intermittent fever. 

Prognosis. — The prognosis of simple intermittent fever 
is always favorable. The inflammatory variety sometimes 
proves fatal by complicating some of the important struc- 



I40 THEORY AND PRACTICE OF MEDICINE. 

tures. The pernicious variety is an exceedingly dangerous 
disease. But if the patients are seen at the beginning of the 
attack, and treated promptly, a large proportion of the cases 
will recover. 

Treatment. — The treatment of simple intermittent 
fever must be adapted to the stage in which the patient is 
first seen. If he is seen in the cold stage, he must be cov- 
ered with warm blankets, and have bottles, or rubber bags, 
filled with hot water placed about his feet, legs, and back. He 
may have a cup of warm tea, coffee, or beef extract. It is a 
dangerous practice to stimulate much in the cold stage, for 
it will increase the febrile excitement when the hot stage 
comes on. And if the case should prove to be of the inflam- 
matory type, it would be greatly aggravated by the stimulant. 
The remedies that are indicated in the cold stage are aconite, 
camphor, and gelsemimn. When the hot stage comes on then 
aconite and gelsemium will modify and control the fever. As 
a general rule gelsemium is indicated in warm climates, while 
aconite acts better in cold climates. But the fever remedy 
must be selected in accordance with the symptoms present. If 
there is intense thirst for large draughts of water at short in- 
tervals, and if there is great fear, then aconite is the indicated 
remedy. But if there is chilliness followed by fever without 
thirst, then gelsemium will be the indicated remedy. 

After the chill and fever abates, then we must select the 
remedy by the symptoms present, to prevent the return of 
the paroxysm, if the aconite and gelsemium, already men- 
tioned, are not the indicated remedies to cover all symptoms 
present. 

It becomes an important question as to how medicines act, 
or upon what part of the human organism do their dynamic 
force play, in order to arrest chills and fever. 

I have already stated that writers agree that miasmata is 
of vegetable origin ; and is propagated by vegetable decompo- 
sition, and enters the system, both by inhalation and by water 
being impregnated with miasma, and taken into the stomach. 



THEORY AND PRACTICE OF MEDICINE. I4I 

But the question is not yet settled, as to the character of 
miasma. Some believe it to be a catalytic agent by which 
zymosis takes place, and a blood poison is generated, and con- 
veyed to the nervous centers through the circulation. Thus 
a peculiar morbid impression is transmitted from the nervous 
centers to the muscles over which they preside, and produce 
that singular phenomena observed in miasmatic patients. 

Others believe it to be animalcules, called bacilli, which are 
conveyed through the circulation and deposited in the spleen, 
and produce by their presence an irritation or inflammation of 
that organ which serves as a nucleus from which to send 
forth their poison by reflex action or otherwise to the nerves 
which preside over the muscles of voluntary action. 

Those who have taken the latter view of the subject be- 
lieve that quinine cures intermittents by its tonic effects upon 
the capillaries and venous radicals of the spleen, or by causing 
contraction or diminution of that viscus, and thereby arrest 
further congestion and inflammation. This- is a very plaus- 
ible theory, for nearly every person living in malarious dis- 
tricts have larger spleens than those living in non-malarial 
countries. But homoeopathy furnishes many agents to cure 
chills and fevers where the morbific agent concentrates its 
force on other organs than the spleen. It is true that the 
symptoms in those organs may be only of a reflex character 
from the spleen. If that be the case then the question arises 
how do homoeopathic medicines cure chills. I say cure be- 
cause that is the term in common use. But when I tell you 
that crude drugs often kill and never cure any thing, then you 
may ask me why do we give medicines. I answer to assist 
nature ; and hence the proper term to express their action 
would be assistants. For nature performs a cure by the assist- 
ance of the dynamic force of drugs. That is to say, if the 
morbific agent is located in the spleen, and is sending out its 
reflex force to overpower the nerve centers, and thus depress 
organic functions ; then if you select a drug whose physiolo- 
gical action is similar to the symptoms produced by the bac- 



142 THEORY AND PRACTICE OF MEDICINE. 

teria, then by giving that drug in potencies you arouse the 
flagging energies of the organic functions, and thus enable 
them to attack the bacteria in the spleen and expel them. The 
plastic condition of the blood having been increased by the 
dynamic force of drug action the bacteria are incased with 
plastic lymph and are carried out of the system through the 
excretory ducts. I have already told you that the plastic sys- 
tem will not tolerate the presence of a foreign substance. 

I will now mention a few of the most important remedies 
for remittent fever alphabetically. I have already called your 
attention to the remedies in the cold and hot stages, and now 
refer to those remedies which have the power of assisting 
nature in restoring the system to its normal condition. You 
must remember that each case you are called to treat may re- 
quire different remedies. That is, you must select the remedy 
to cover the symptoms in each case. 

I may remark that, where the patient is incapable of giv- 
ing an intelligent history of his case, or if the paroxysms 
come on at irregular intervals, you check the fever with one 
of the indicated remedies, and follow with china or arsenicum, 
until you can get a correct diagnosis of the symptoms. 

Antimonium tart — Chilliness predominates, desire to 
sleep, and want of thirst. 

Apis. — Chill about 4 p. m. (lycopodium\ worse in a warm 
room or near a stove. Sensation in the abdomen as if some- 
thing would break, if much effort were made to void a stool. 

Arjiica. — Chill in the evening. Thirst before and during 
the chill. Sore, bruised feeling all through the body, as if it 
had been beaten. The bed or couch on which he lies feels 
too hard. Sepia and sulphur have similar symptoms. 

Arsenicum. — During the fever, great anguish, extreme 
restlessness and fear of death. After the paroxysm, great 
prostration. Urgent thirst, drinking often but little. 

Belladonna. — Has slight chill, with much fever, or vice 
versa. Heat and red face, with throbbing of the carotids ; 
choking sensation in the throat, with dry mouth. 



THEORY AND PRACTICE OF MEDICINE. 143 

Bryonia. — Great thirst during all stages. Violent, dry, 
racking cough, with stitching pains in the side of the chest ; 
stitching pain in the region of the liver and abdomen. Hard 
dry stools, as if burnt. Exceedingly irritable ; everything 
makes him angry. 

Carbo veg. — Thirst only during the chilly stage. When 
eating or drinking, sensation as if the stomach or abdomen 
would burst. 

Cedron. — Chill occurs at 5:30 p. M. Numb, dead feeling 
in the legs ; they feel enlarged. The entire body feels numb. 
Cedron is considered a true anti-periodic ; that is, the symp- 
toms reappear at regular intervals. It is also good for period- 
ical neuralgia. 

Chamomilla. — Face red, or one cheek red and the other 
pale. Very impatient, can hardly answer one civilly. Pain 
in the abdomen, with frequent emissions of large quantities 
of pale urine. 

China or quinia. — The paroxysm is preceded by nausea, 
headache, hunger, anguish, and palpitation of the heart. 
Thirst before the chill, and during the sweating stage. Chills 
alternate with heat, skin cold and blue ; ringing in the ears, 
with dizziness and a feeling as if the head was enlarged. 

Eupatorium purpureum (trumpet weed). — Chill commenc- 
ing in the back, and spreading over the body ; violent shaking, 
with comparatively little coldness. Violent pains in the 
bones during the chill and heat. 

Ferrum. — Vomiting everything eaten without being di- 
gested. The least emotion or exertion produces a red flushed 
face ; great loss of muscular power. 

If you find protracted cases treated by quinine in large 
doses ; then a few doses of nux vomica followed with ferrum 
will usually give you good results. 

Gelsemium. — This is the best remedy you can select for 
intermittents during the fever in warm climates. It is also 
advised as a prophylactic. It is indicated for the chill when 



144 THEORY AND PRACTICE OF MEDICINE. 

followed by restlessness . and nervous anxiety. The patient 
feels tired. 

Hepar sulphur. — This is indicated by itching, stinging 
nettle-rash before and during the chill. It is also called for 
when fever blisters occur around the mouth. If the patient 
has been abused by the use of crude mercury, then hepar is 
your remedy. I have already told you that if he has been 
abused by crude quinine then ferrum is the remedy after an- 
tidoting the quinine with nux vomica. 

Ignatia. — Thirst only during the chill. The chill is re- 
lieved by external heat. During the fever nettle-rash over the 
whole body. 

Ipecac. — No thirst in the cold stage, but a great deal in 
the hot. Nausea and vomiting predominates. The apyrexia 
is marked by more or less gastric disturbance. 

Lachesis. — Much chattering of the teeth, with violent head- 
ache and soreness in the chest. Patients desire to be held on 
account of the violence of the chill hurting the head and chest. 
Can bear nothing to touch the throat or neck. 

Lycopoolium. — The paroxysm comes on about 4 p. m., and 
terminates about 8 p. m. Red sediment like sand in the urine. 
Great fear of being left alone. 

Natrum muriaticum. — Chill commencing at 10 A. M., with 
great thirst, drinking often and much at a time During the 
heat violent headache. Dry tongue, and ulcerated corners of 
the mouth. 

Nux vomica. — Paroxysm usually at night or early in the 
morning. Long lasting, hard chill, with bluish cold face and 
finger-nails. Great heat, notwithstanding the patient wants 
to be covered up. During the fever, headache, vertigo, red 
face, pain in the chest and vomiting. 

When you get a patient, from the allopaths, who has been 
dosed with crude quinine, and has the above symptoms, then 
nux vomica will cure without the aid of any other remedy ; 
when you get rid of the surplus of quinine you cure the patient. 
But if he has not the nux vomica symptoms, you must give a 



THEORY AND PRACTICE OF MEDICINE. I45 

few doses to antidote the quinine and other crude medicine, 
before giving the indicated remedy. 

Rhus tox. — During the hot stage, nettle-rash breaks out. 
Restlessness, and constantly changing position. Dry, teasing 
cough, before and during the chill. 

Sepia. — Great coldness of the hands, with sensation as if 
the fingers were dead. Perfect absence of thirst. 

Sulphur. — Has a burning heat on top of the head. Fre- 
quent weak spells through the day. Early morning diarrhea. 
Sulphur is what is called an intercurrent remedy. That is to 
say, if the others do not cure quickly, then it is claimed that 
a few doses of sulphur, where it is not the indicated remedy, 
will develop the symptoms so clearly that you can readily 
select the indicated remedy. 

Veratrum album. — Severe chill, with feeling of internal 
heat, or both together. Profuse sweat, often cold and long 
continued. Great exhaustion and sinking of strength. 

There is a form of intermittent fever called dumb ague. 
That is, there is no regular chill and no regular periodicity of 
fever. The patient complains of feeling badly, he feels cold 
sometimes ; and then he feels hot. As those cases have only 
been observed among patients who had been dosed with crude 
quijiine and arsenic, it is now believed that there is no such 
disease. But simply quinine and arsenical slow poisoning. 
This is demonstrated by the fact that carbo veg., cedron, ipecac. 
and nux vomica will generally relieve. Nux may be given 
first, and followed by the others if relief is not obtained. 

Treatment of Inflammatory Intermittents. — x\s 
the fever runs high in this type ; and as our efforts must be to 
prevent the spread of inflammatory action, we must be careful 
to select the most appropriate agent to meet the present emer- 
gency. The remedies indicated are aconite, gelsemium, and 
veratrum viride. If the carotids are bounding and there is 
intense thirst for large quanties of water at short intervals, and 
if the disease is concentrating its force on the stomach, then 



146 THEORY AND PRACTICE OF MEDICINE. 

aconite is called for. But if there is nausea, and cerebral com- 
plications, veratrum viride is the indicated remedy. If the 
patient complains of a tired feeling with spinal irritation and 
pain in the back part of the head, then gelsemium is an inval- 
uable remedy. If actual inflammation of the brain, and its 
meninges, become involved then you must also look to bella- 
donna for relief. 

After the inflammatory fever begins to abate, and if the 
fever remedy does not cover the intermittent symptoms, then 
we must select the remedy that seems to be indicated. If there 
is drowsiness or heavy sleep, with loud snoring during the cold 
and hot stages ; stertorous respiration, with the mouth wide 
open ; congestion of blood to the head, with red and puffy 
appearance of the face, then opium in the 6x to 30X potency 
will almost invariably give relief. Enpatorium perfoliatum 
(boneset) is indicated when there is a determination to the 
portal circulation. The paroxysm usually occurs about 7 or 
9 A. M. During the chill severe aching in the back and limbs 
as if the bones were broken. Vomiting of bile at the conclu- 
sion of the chill. Phosphorus is also indicated for deranged 
liver. 

Splenitis. — This is a frequent complication. The spleen 
often becames greatly distended. I saw a case once where 
the spleen become so large that it filled the left side of the 
abdomen. That case proved fatal, but I have cured cases 
that protruded two or three inches below the margin of the 
ribs. The remedies indicated for enlargement of the spleen 
are agaricus, berberis vulgaris, china, ferrum, mercurius bin- 
iodide. 

Treatment of Pernicious Intermittent Fever. — 
If the pulse is feeble, the extremities cold, and calorification 
impaired, then camphor, arsenicum and veratrum album, are 
called for. These remedies are capable of producing, in over 
doses, symptoms similar to those of the algid form of per- 
nicious intermittent fever. In these cases vou have no time 



THEORY AND PRACTICE OF MEDICINE. 147 

to lose, for sometimes the patients die within a few hours. If 
the case be urgent you can apply a mustard poultice along 
the spine, over the stomach, and on the calves of the limbs. 
This is done to excite an irritation in the cutaneous surface 
and thus invite the circulation from the deeper channels to the 
external capillary system. 

If all of these agencies fail and the case is a desperate one, 
and the circulation very feeble, or the pulse nearly impercep- 
tible, you may strip the patient and dash cold water suddenly 
over the head and body, and then wipe of! quick and roll him 
in dry hot blankets. If reaction does not take place in fifteen 
or twenty minutes, or having reacted and then begin to flag, 
and respiration becomes short, dash again and proceed as before. 
The second or third dashing generally produces reaction if 
there is vitality enough in the system to cause it to respond. 

The modus operandi of the dash consists in this, that when 
cold water is suddenly applied to the body, it causes contrac- 
tion of the capillaries, and thereby forces the blood from the 
capillary system into the deeper channels, and sets in motion the 
blood in the larger vessels. These vessels being set in motion, 
act upon the heart and stimulate it to increased action. Thus 
the whole circulatory system being set in motion, the blood is 
again sent back through the capillary system with an increased 
power. And the rubbing which the patient usually receives, 
and the warmth applied, increase the tone of the cutaneous 
surface, by which the contractile power of the venous radicals 
is kept to work in forcing the blood back again into the larger 
tubes ; and thus the patient is sufficiently revived to gain time 
to remove the cause of the disease and its effects by the use of 
the means already referred to when speaking of the treatment 
of simple intermittents. 

Treatment of Pernicious Typhoid Intermittent: 
— In this form of pernicious intermittent, where vomiting, 
diarrhea, and a low typhoid condition are present, we must 
treat our patient similar to that of cholera and typhoid com- 



148 THEORY AND PRACTICE OF MEDICINE. 

bined. We allow our patient to swallow bits of ice from time 
to time if he is thirsty and vomiting. 

Veratrum album is indicated where there is vomiting of 
black bile and blood. If the matter vomited is grass green, 
then ipecac is the remedy. 

Arsenicum is indicated where the patient is vomiting, 
diarrhea and great prostration. The stools are dark-green, 
or black, watery and very offensive, with pain in stomach and 
bowels. 

After the patient rallies from the typhoid condition, and 
if the periodicity of the disease is not broken, then we must 
select the remedy in accordance with the symptoms as they 
develop. 

I may remark that this type of intermittent fever resem- 
bles cholera so closely that it is sometimes hard to diagnose 
them correctly, especially when cholera is prevailing at the 
time. 

Treatment of Pernicious Feyer of Comatose Type. 
— In this type belladonna may be indicated by a tendency of 
blood to the brain, the pupils are dilated. 

Helleborus is indicated where the patient is stupefied, head 
hot, heavy ; boring head in the pillow ; chilly ; fingers cold. 

Loss of memory, with complete stupefaction requires 
hyoscyamus. 

Gelsemium is valuable for the fever, and a tendency to 
brain complication. 

Opium is indicated when the sleep is heavy, with loud snor- 
ing during the cold and hot stages. 

In the treatment of pernicious intermittent fever, if you 
can get your patient to rally, and carry him safely beyond the 
time for the second paroxysm to return, you will be almost 
sure to cure him. But if you let the golden opportunity pass 
unnoticed, or imagine that you have only a simple case to con- 
tend with, twenty-four or thirty-six hours may bring the sad 
reality to your mind, that you have lost your opportunity, and 
sacrificed your patient. 



THEORY AND PRACTICE OF MEDICINE. 149 

REMITTENT or BILIOUS REMITTENT. 

This is an idiopathic disease of the periodical variety. 
Ivike the intermittent it has three grades — simple, inflamma- 
tory, and pernicious — and three stages, the cold, hot, and 
sweating. But it differs from intermittent in this, that the 
chill is not so severe ; the cold stage is shorter ; and the hot 
stage is longer ; lasting eighteen, or nearly twenty-four hours. 
Generally at the end of eighteen hours from the chill, there is 
a remission w T hich lasts from one to six hours before the next 
paroxysm comes on. 

Symptoms of Simple Remittent. — The patient com- 
plains of soreness of the muscles, and distress in the epigastric 
region, for some time before the fever sets in. He continues 
about his work ; but feels badly, and has but little appetite. 
At length his head becomes painful especially across the brows ; 
he feels a cold sensation creeping over him, which soon ends 
in a slight chill that lasts from fifteen minutes to half an hour. 
The face is pale, and the lips are of a purple hue ; the pulse is 
generally small and irregular in this stage. As the chilly sen- 
sation begins to pass off, it is succeeded by flashes of heat ; the 
pulse becomes more frequent ; the skin is hot and dry ; the 
head, loins, and limbs are painful ; the tongue is covered with 
a thin yellowish coat ; the appetite is impaired, nausea is often 
present ; and the face and eyes are of an icteric or yellowish 
hue. The fever lasts about eighteen hours, when a remission 
takes place. The patient becomes drowsy, and passes into a 
disturbed muttering slumber. After the patient remains in 
this condition for a short time, there is a slight perspiration 
breaks out upon the forehead. When he awakes his muscles 
and head feel sore as though he had been beaten. Sometimes 
the cold stage and the remission are so slight that we can 
hardly tell when they begin or end ; and unless we are on our 
guard, we may make a mistake as to the true character of the 
disease. 

Simple, uncomplicated, remittent fever may last from seven 



150 THEORY AND PRACTICE OF MEDICINE. 

to ten days, alternating with the paroxysms and remissions, 
and pass off with a copious perspiration, either with or without 
treatment. But there is another type which is more difficult 
to manage ; this we call the 

Inflammatory Remittent. — This differs from the sim- 
ple variety only in the degree of its severity. In the begin- 
ning it has all of the characteristics of the former ; but as 
the disease advances the evidence of complication is soon man- 
ifest. The pulse becomes quick, ranging from no to 120; 
the skin is hot and dry ; the tongue is coated with a thick 
yellowish fur ; appetite is entirely lost ; thirst is intense ; the 
bowels are costive, and nausea and vomiting are almost con- 
stant. The ejections consist of a greenish or yellowish fluid, 
of a bitter taste ; sometimes it consists only of mucus. The 
pain, tenderness, and oppression call our attention to a com- 
plication or trouble in the stomach. The tenderness of the 
right hypochondrium ; the yellowness of the skin and con- 
junctiva membrane, and the scanty, yellowish brown urine 
give unmistakable evidence of congestion of the liver and 
portal circulation. The headache, which was of a mild char- 
acter in the simple variety, often becomes intense in this. 
The patient is sometimes wakeful ; and at other times he is 
drowsy with muttering delirium. The disease continues un- 
abated, and retains its paroxysmal character until about the 
seventh or fifteenth day, when it either begins to decline or 
becomes aggravated. 

The first indication of a favorable change is to be found 
in the character of the pulse. It becomes less frequent ; the 
skin feels soft ; the tongue becomes moist and begins to clean 
from the tip and edges. If a paroxysm ends in a copious 
perspiration, or a bilious diarrhea, or puts on the intermit- 
tent character, we may look for a favorable result. Little 
vesicles often appear about the lips ; and they coalesce and 
form considerable sores. These are prognostic signs of recov- 
ery. If at the time specified, the disease does not take the 



THEORY AND PRACTICE OF MEDICINE. 151 

favorable turn which I have just described, the symptoms be- 
come aggravated. The pulse becomes frequent, ranging from 
120 to 140 per minute; the tongue becomes dry and brown; 
sordes gather around the teeth ; the disease loses its parox- 
ysmal character, and we have all the symptoms of a typhoid 
condition. 

Hiccough is sometimes troublesome ; the urine is scanty, 
or suppressed ; the patient becomes delirious ; he imagines that 
he is away from home among strangers ; he picks at the bed- 
clothes or imaginary objects ; the stools are passed involun- 
tarily ; the pulse grows frequent and feeble ; the patient 
becomes comatose ; and often dies in this condition. How- 
ever, the disease does not always end in the manner that I 
have thus described. But, on the other hand, a large majority 
of the cases may end favorably in from three to four weeks, if 
they are properly treated. 

Pernicious Remittent. — This is often a most fatal vari- 
ety of remittent fever. It begins as a simple remittent ; and, 
often, when we are expecting to see the patient pass into the 
paroxysm, he suddenly sinks into a low typhoid condition, 
out of which it is difficult to arouse him. The tongue, which 
at first was covered with a yellowish fur, now becomes brown 
in the center ; the tip and edges are red, and sordes begin to 
gather on the gums and lips. After a short time the brown 
coat comes off, leaving the tongue red and dry. The dis- 
charges from the bowels are thin and watery and of a yellow- 
ish color ; the eyes are stained with bile ; and there are 
frequent vomitings of bilious matter. The bile is the effect 
of the disease and not the cause. The patient is liable to 
sink into a comatose condition and die suddenly. But with 
timely aid he may be brought through the paroxysm and 
linger for a few days in a low typhoid condition, out of which 
he is gradually raised and finally recovers. 

I have to reiterate the same advice in this case that I gave 
in pernicious intermittents, that is to arrest the paroxysm as 



152 THEORY AND PRACTICE OF MEDICINE. 

speedily as possible ; for what appears to be a simple attack 
may at the next paroxysm prove to be pernicious, and the 
patient be lost before we can have time to arrest the disease. 

CatlSC — The cause of remittent fever is undoubtedly of 
miasmatic origin. But it is difficult to explain why it is that 
of two patients affected by malaria, one should have intermit- 
tent and the other remittent fever. As remittent or bilious 
fever generally prevails at the close of hot summer months, 
we may infer that heat not only liberates malarial poison ; but 
that it has much to do in changing the diathesis of the patient ; 
or it so affects the functions of the liver as to render it suscep- 
tible to the influence of malaria ; by which it is readily con- 
gested, and prevents the escape of bile through the proper 
channels. Thus the bile being retained in the liver it is re- 
absorbed, circulates through the system with the paludal 
poison ; and thus produces the phenomena peculiar to remit- 
tent fever. We may have a jaundiced appearance of the skin 
brought about by the heat of the sun in non-malarial districts ; 
but we do not have the paroxysms and periodicity of fever, as 
is observed under similar circumstances in malarial districts. 

I am of the opinion that it is a catalytic change which 
takes place by the union of bile and miasmata, that makes the 
difference between remittent and intermittent fever. It is a 
well established fact that bilious remittent fever prevails 
more generally and extensively in the malarial regions of hot 
climates than it does in cold regions, while intermittent fever 
is more prevalent in the latter. Thus it appears that there is 
another element besides marsh malaria necessary to be present 
to produce remittent fever, and that element seems to be an 
abnormal product of the liver, induced by an augmentation of 
solar heat. 

Morbid Anatomy. — The most constant pathological 
change observed after death from bilious remittent, is to be 
found in the stomach, spleen, and liver. The mucous mem- 
brane of the stomach gives evidence of congestion and inflam- 
mation. The spleen is enlarged and softened. And the liver 



THEORY AND PRACTICE OF MEDICINE. 1 53 

is greatly enlarged, changed in color, and softened. The 
meninges of the brain sometimes give evidence of inflamma- 
tory action. These are the only anatomical changes worthy 
of note in this disease. 

Diagnosis. — The diagnosis of remittent fever is gene- 
rally easy. The regularity of the paroxysms of this disease 
distinguishes it from the continued fevers. But, as I have 
already stated, the cold and sweating stages are sometimes so 
slight that we have got to be on our guard, or else we might 
overlook them. But generally the careful practitioner need 
make no mistake. Remittent fever may be distinguished from 
the intermittent in view of the fact that the cold stage is 
longer, the hot stage is shorter, and the sweating is more copi- 
ous in the latter than in the former. And the patient feels 
freer from the effects of the disease during the interval in inter- 
mittent than he does in remittent fever. 

Prognosis. — The prognosis of remittent fever is gene- 
rally favorable. The simple variety is always favorable unless 
the constitution has already been shattered by some previous 
cause. The inflammatory type seldom proves fatal in plastic 
patients if treated properly. But if it occurs in the aplastic 
system it is sometimes very troublesome to treat. 

The pernicious type of remittent fever is a very fatal dis- 
ease in some latitudes. But even this is amenable to treat- 
ment, and many cases recover. The bilious remittent of hot 
climates is a much more difficult disease to manage, than the 
milder forms of the same grade occurring in cold climates. 

Treatment. — The simple remittent fever may be treat- 
ed upon the same general principles as I laid down for simple 
intermittent. 

Precursory Stage. — Camphor for severe chills, chatter- 
ing of the teeth, pallor of the countenance, sense of internal 
heat, cold sweats, cramps and purging. 

Gelsemium is indicated for cold hands and feet, with op- 
pressed breathing. Chilliness every day a.i the same hour, 



154 THEORY AND PRACTICE OF MEDICINE. 

especially in the morning. Coldness of the feet as if they 
were in cold water. 

Hot Stage. — Aconite, belladonna, and gelseminm. 

Inflammatory Remittent. — In all remittent fevers, I 
care not what is the type, there is a pathological condition of 
the portal system, either of the liver, gall duct, or the portal 
veins. This is known by the fact of the icteric or jaundiced 
appearance of the skin. 

There are many homoeopathic remedies that are suitable 
for portal congestion, but I mention only three that are usu- 
ally sufficient in this fever. Mercurins gives a sensitive 
liver, jaundice with bad taste, tongue moist and furred, and 
yellow. Phosphorus produces diffuse hepatitis with jaundice, 
and may be carried so far as to produce malignant jaundice. 
Just the condition we often find in bilious remittent fever. 

Podophyllum. — This remedy has for its symptoms exces- 
sive secretion of bile, great irritability, and torpidity of the 
liver, with jaundice. 

Gastric Type of Inflammatory Remittent. — Ar- 
senicum is indicated where there is vomiting of bitter, green- 
yellow liquid, brown, turbid, black bloody matter. Intense 
heat and burning in the pit of stomach. 

Ipecac has vomiting of grass-green substance, with contin- 
ual nausea. 

Argentum nitricnm has symptoms similar to the agents 
already mentioned, and so has veratrum album. 

Treatment of Cerebral Remittent. — Belladonna is 
one of the first remedies to be thought of in this condition, 
when there is violent throbbing headache, with stupefaction. 
Heat and red face, with throbbing of the carotids. Choking 
sensation in the throat, with dry mouth. 

Hyoscyamus is indicated where there is delirium without 
consciousness ; does not know his own family. Delirium, 
with jerking of the limbs, wild staring look, or closed eyes. 



THEORY AND PRACTICE OF MEDICINE. 155 

Strammonium is indicated where the patient is jerking the 
head up from the pillow, and letting it drop back. 

Opium is indicated when coma supervenes, with loud 
snoring. 

Coffea cruda is indicated when patient cannot sleep. If he 
is sleepy and cannot sleep then belladonna is indicated. 

Treatment of Pernicious Typhoid Remittent. — In 
this condition arsenicum, baptisia, and muriatic acid are 
indicated. Arsenicum has pale face, shrunken, hollow, and 
cadaverous, or yellowish, bluish, or leaden colored. Cold 
sweat on the head. Constant licking of the lips, which are 
dark, dry, and cracked, with sordes on the teeth. Tongue dry, 
shriveled, bluish, or black, with inability to protrude it. In- 
tense thirst, drinking often, but little at a time. 

You will remember that the indication for baptisia is an 
offensive odor arising from the patient's body, or the excre- 
tions are offensive. The patient complains of a feeling as 
though his body was scattered around in pieces, and he is en- 
deavoring to gather up the pieces. Muriatic acid is called for 
where there is constant sliding down in bed. I^ow, muttering 
delirium, groaning in sleep, and picking at the bed-clothes. 
Inability to protrude the tongue which is very dry. Depres- 
sion of the lower jaw, boring the head into the pillows, turn- 
ing up the whites of the eyes. 

Veratrum album is indicated where there is nausea and 
diarrhea. The matters vomited are of a brownish color, often 
mixed with blood. 

The diet and hygienic regulations as recommended in in- 
termittent fever must be observed in remittent fever. 

Sequelae of Malarial Fevers. — In all malarial re- 
gions the inhabitants are liable to be affected by a train of 
symptoms or morbid conditions ; for which we have no name. 
And many pathological changes of malarial origin are some- 
times hard to determine on account of the obscurity of its 
action. Every practitioner has been consulted by patients in 



156 THEORY AND PRACTICE OF MEDICINE. 

whom he could detect no disease ; and yet the description 
which the patient gave of his feelings was an evidence that 
some change was going on in the animal economy. 

To illustrate this subject I may remark that I was once 
called in consultation to see a lady who had paroxysms of 
vomiting every twenty-one days. Those paroxysms had con- 
tinued regularly for three months, and each attack of vomiting 
would continue more or less severely from three to six days. 
During the interval she was comparatively well except that 
she was pale and somewhat emaciated. After a careful exam- 
ination I could detect no lesion of the stomach, and the other 
organs w T ere performing their regular functions though feebly. 
The attending physician informed me that he had exhausted 
the allopathic materia medica of nervines and anti-emetics 
without any relief. While in consultation, and in doubt as 
to the cause and the remedies to be used, I noticed that the 
house was standing on the edge of a slough or marshy land 
which was half a mile in diameter. iVlthough the ground 
was covered with snow, and the slough was frozen to a great 
depth — for it was in a cold latitude and in the month of Janu- 
ary — I was satisfied, from the periodicity of the vomiting, that 
the malaria which had been taken into the system during 
the fall was the cause of the trouble. 

I advised the administration of quinine to arrest the perio- 
dicity of the vomiting, and she had but one slight attack after 
that remedy was administered. Don't be startled when a 
homoeopath speaks of giving quinia, for it was homoeopathic 
to that case, and thereby it arrested the symptoms. The law 
of cure was founded upon the action of quinine, the alkaloid 
of cinchona, and hence when it is homoeopathic to any par- 
ticular case it will cure in the 3X or 30X potency as readily as 
the crude drug. When a remedy is capable of producing phy- 
siological symptoms similar to those of the disease present, 
then that agent is capable of arresting those symptoms, whether 
given in the crude state or in potencies. That is to say, when 
a remedy is homoeopathic to the symptom of any disease it 



THEORY AND PRACTICE OF MEDICINE. 157 

will relieve those symptoms whether administered by an 
allopath or a homoeopath. But we find by experiment that a 
remedy acts more speedily and safely when potentized. There- 
fore homoeopaths have as much right to use quinine when it 
is homoeopathic as the allopaths have. Hahnemann took 
drachm doses of pulverized Peruvian bark until he produced a 
set of symptoms similar to those produced by malaria ; hence 
he cried out, " Similia similibus curantur" — like cures like. 
In view of this fact, and as quinine is the alkaloid of Peruvian 
bark, then have we not the right to claim it as homoeopathic 
and to use it when indicated. Most assuredly we have, and if 
you can cure a patient with the first, third, thirtieth, or two 
hundredth potency it is no one's business but your own, so that 
you prescribe in accordance with the law. 

There are three forms of disease, or pathological conditions, 
which are liable to follow in the train of malarial fevers ; or 
they are liable to occur in persons, in malarial districts, who 
have not been subject to intermittent and remittent fevers. 
Those conditions are known as periodical neuralgia, dropsy, 
and enlargement of the spleen and liver. 



PERIODICAL NEURALGIA, or BROW AGUE. 

This disease may begin by a sense of coldness, followed by 
fever and pain in the head or face. Sometimes the cold stage 
is so slight that it can only be detected by an examination of 
the fingers, or tip of the nose and ears. Sometimes the fever 
is considerable, but more generally it is mild or entirely want- 
ing. The pain is in one temple and cheek ; or it may occupy 
the brow alone, or the side of the head. The pain generally 
comes on in the forenoon, and passes off in the afternoon. 
Sometimes the pain will begin as the sun rises, and increase 
in severity as the day advances ; and then declines with the 
day, and when the sun has set the patient is entirely free from 
pain until the rising of the sun the next morning. The perio- 
dicity of the disease is an evidence of its malarial origin. 



158 THEORY AND PRACTICE OF MEDICINE. 

Treatment. — The remedies usually indicated in this 
affection are arsenicum, belladonna, berberin sulphas, cedron, 
chelidoniiun, cimicifuga, glonoine, kali biehromicum, mix vom- 
ica, and sulphate of quinic. 

Cedron, berberin and quinia, act as antiperiodics, in the 
first and second potencies, in all periodical neuralgias. 

Strammonium — Headache, morning, worse toward noon, 
gradually decreasing toward evening, pains terrible. Some- 
times patient delirious, talks incessantly, tongue thick and 
heavy. 

Dropsy is not a disease, but a pathological state induced 
bv a morbid condition of the organic functions. I will there- 
fore take up the subject when I come to local diseases. I have 
already called your attention to the inflammation and enlarge- 
ment of the spleen, and the typho-malarial condition of the 
liver. 

YELLOW FEVER. 

(Febris Flaya.) 

While this fever resembles, somewhat, bilious remittent, 
and the causes, in many respects, are similar, yet it does not 
properly belong to periodical diseases. Neither is it strictly 
a continuous fever ; but it is a disease peculiar to itself, and 
only developed in tropical climates. 

Symptoms, — In the first stage of this disease it resem- 
bles the premonitory symptoms of other fevers. That is to 
say, there is a slight indisposition for several days before the 
fever is developed. Xausea and vomiting are of frequent oc- 
currence. The patient complains of chilliness, sometimes 
there are rigors with pain in the head and back. The chill 
mostly occurs in the night, the fever is intense, skin dry and 
burning, pulse running from 120 to 140 beats per minute, 
temperature is ioi c to io6 c , thirst is great. The eyes are 
burning, red, and watery. The tongue is coated with a brown 
or yellowish cast. There is often pain in the stomach with 



THEORY AND PRACTICE OF MEDICINE. 1 59 

nausea and vomiting of bilious mucous matter. These symp- 
toms last from twenty-four to sixty hours when they abate, 
and the second stage is developed. In this stage the fever 
abates, pulse falls from 140 to 70, or 50 beats per minute, the 
skin is moist, tongue cleans, the patient sleeps, and thus he 
seems to be convalescing. In mild cases the disease often 
terminates in complete recovery. But you must be on your 
guard, for the second stage may be the calm before the storm, 
which ushers in the third stage. During the second stage the 
utmost care must be observed as to diet, ventilation and exer- 
cise of the patient. If the eyes assume a " lemon tint," the 
mind is wandering, and the pulse very slow, then you may be 
sure that the third stage will soon supervene. 

The third stage is marked by profound collapse ; injection 
and yellowness of the eyes ; burning in the stomach, ascend- 
ing towards the throat ; pain, sometimes severe, in stomach 
and bowels ; dark-colored urine and diarrhea ; increasing yel- 
lowness of skin ; oozing of blood from the gums and throat ; 
and even hemorrhage from various organs ; constant tossing 
about and sleeplessness ; delirium, mild and muttering, or 
furious ; eructations, hiccough, and frequent vomiting of yel- 
lowish-brown or claret-colored, or tarry-like liquid, or of 
mucus or phlegm mixed with brown or black specks, or of 
blood more or less pure. Unless the disease be arrested, the 
much-dreaded black-vomit ensues, consisting of vitiated blood, 
and resembling coffee-grounds, or water in which snuff or soot 
is suspended, to the consistency of thin molasses. Total 
suppression of urine, or reddish-dark urine, bluish or black 
patches on the skin, profound coma and convulsions, often 
precede death. There is one peculiarity about this disease, it 
renders patients indifferent as to death ; they do not seem to 
care whether they die or not. 

Pathology. — The lungs, though they are generally 
healthy, sometimes show signs of sanguineous engorgement. 
Traces of inflammation are occasionally noticed in the kidneys 
or bladder. The liver is variously affected, being sometimes 



l6o THEORY AND PRACTICE OF MEDICINE. 

engorged with blood, sometimes dry, ansemic and of a yellow 
color, rarely inflamed. The force of the disease is expended on 
the alimentary canal, especially on the stomach. It contains 
black vomit. The bowels contain the characteristic black 
matter. Dr. R. D. Arnold, of Savannah, has always found 
the liver pale and destitute of blood, and presenting a yellow- 
ish color, resembling that of boxwood. In all cases examined 
by him there was a total absence of bile in the alimentary 
canal. Microscopic observations by Prof. Clark, of New York, 
and Drs. T. H. Bache, Rhodes, Darrach and Green of Phila- 
delphia, have shown that a great excess of oil generally exists 
in the liver, both free and within the proper hepatic cells, in 
which they frequently replace the nucleus ; so that fatty de- 
generation of that organ may be considered as one of the 
characteristic lesions in fatal cases of yellow fever. 

Cause. — This disease is no doubt caused by a direct 
specific virus generated in tropical climates with an average 
temperature of 72 ° F. The bacillus is supposed to be gene- 
rated by vegetable decomposition in hot climates. It is evi- 
dent that the morbific agent of yellow fever is different to 
that of remittent or bilious fever ; for yellow fever is endemic 
in low districts near the sea in tropical climates ; while bilious 
remittent fever is endemic in the southern states of the United 
States of America. That is to say, the bacillus of yellow fever 
cannot be generated in this country ; but when they are 
brought here from the Islands the conditions of climate are 
sufficient to cause the bacteria to be propagated from indivi- 
dual to individual until a frost comes and kills them, and thus 
the disease is arrested. In the low lands of Cuba the bacillus 
are ever present ready to develop bacteria, when the animal 
tissues are in a certain condition. It is said that they are never 
developed 2,500 feet above sea level. It is said that the high 
lands of Cuba are exempted from bacillus, but if any of the 
inhabitants from the highlands visit the coast they are liable 
to yellow fever. 

I do not know whether I have made the subject sufficiently 



THEORY AND PRACTICE OF MEDICINE. l6r 

intelligible or not ; but I want to impress the fact upon you 
that our whole country is exempt from yellow fever germs 
unless brought here from their native home in the tropics. 
When once here they find atmospheric, and other conditions, 
sufficient to cause the spread of the disease until frost termi- 
nates their existence. This being true, then the general gov- 
ernment is remiss in its duty in not quarantining our southern 
coasts to prevent the landing of any vessels from yellow fever 
districts. 

The theory is advanced that a compound salt radical, 
called cyanogen, formed in the mud of rivers by decomposi- 
tion, is the cause of yellow fever bacillus. Cyanogen is the 
component of hydrocyanic or prussic acid. What ever may 
be the cause, it is evident that the morbific agent of yellow 
fever may be carried from one country to another and cause an 
epidemic to prevail. 

Diagnosis. — In many respects yellow and remittent 
fevers resemble each other. But when you remember that in 
remittent fever there is a slight remission of the fever for a 
short time, when it again runs its course ; and a remission 
occurs once in twenty-four hours ; while in yellow fever it runs 
its course in from twenty-four to sixty hours and terminates in 
the second stage, when there is no fever, for a longer or shorter 
period, until the third stage is developed, when there is no 
doubt left as to the character of the disease. Post mortem re- 
veals the fact that the stomach is inflamed both in yellow and 
bilious fevers, but it rarely contains the true black vomit in 
bilious fever. The liver in yellow fever is often bright-yellow, 
dry, and anaemic ; in bilious, it presents wholly different phe- 
nomena. The gall-bladder in the latter is usually distended 
with black bile, in the former it is seldom distended, and often 
contains less than in health. The spleen, in bilious fever, is 
almost always enlarged and softened, in yellow fever it is often 
little if at all changed. 

Prognosis. — In former years yellow fever has been a 
very fatal disease. In many epidemics 95 per cent. die. The 



1 62 THEORY AND PRACTICE OF MEDICINE. 

old school are more successful now than in former years. 
Some years ago the statistics from various European hospitals 
showed a mortality of 55 per cent.; while in the same epi- 
demics the homoeopathic school lost but ten per cent, in some 
hospitals, and 12 per cent, in others. That makes a wonder- 
ful showing in favor of the new school. 

Yellow-fever is specially fatal to drunkards, delicate wom- 
en, and children. It attacks persons with light hair and fair 
skin more readily than others. It is very mild when occur- 
ring in the natives of the tropics, also in Frenchmen, Italians, 
and Spaniards. It is more severe in the whites of North 
America, and still more so in Englishmen, and most fatal to 
Irishmen and Germans. It prevails mostly in the summer 
and autumn months. Its average duration is a week, and the 
most fatal period is from the third to the sixth day. Those 
who surmount the black vomit sometimes perish from exhaust- 
ing abscesses, consequent upon the depraved state of the blood. 
A total suppression of urine may be regarded as a certainly 
fatal symptom in adults. In all cases terminating fatally, 
albumen appears in the urine on the second or third day. 

Treatment. — First Stage. — Camphor \§ indicated on 
account of chills and shivering. The skin feels cold but 
patients refuse to be covered. 

After the fever sets in you must make a judicious selection 
of the fever remedy. Generally the first to be thought of is 
aconite. But you must remember what I have already told 
you of the distinguishing, or grand characteristics of each 
remedy ; you remember that aconite has a full bounding pulse 
with intense thirst for large quantities of water at short inter- 
vals. 

Belladonna has bounding carotids, reddish face, headache, 
red staring eves, and inclined to quarrel and fight. 

Bryonia is indicated where there is thirst for large draughts 
of water at long intervals. Patient feels worse when moving, 
nausea when rising from couch. 



THEORY AND PRACTICE OF MEDICINE. 163 

Gehemium is required when there are severe pains in back, 
and back of head, nausea, and has a tired feeling. 

Arsenicum is rarely indicated in the febrile excitement of 
yellow fever. But you must remember that in all cases where 
there is intense thirst every few minutes, but the patient only 
takes a sip at a time, and he is tossing his hands and feet 
about, then arsenicum is your main remedy. 

This is a disease that needs close attention, so as to meet 
any symptom that may arise. If you give your one remedy 
and do not visit your patient for twenty-four hours you may 
find new symptoms developed, and beyond the reach of the 
indicated remedy. 

When there is nausea in the first stage, you may have to 
give ipecac or antimonium tartaricum. The remedies to which 
I have already referred, are all that you need for the first stage. 

Second Stage. — You will remember that this stage is 
characterized by a cessation of all of the symptoms. This is 
called the critical time, for an error in diet and treatment, and 
the patient will be lost The patient must have nutritious but 
unirritating diet, and should remain in bed, and be kept com- 
fortably warm. As soon as the fever abates then you should 
give mercurius, as in this disease there is always congestion of 
the portal system. If there are dark liquid evacuations from 
the bowels, then podophyllum is a valuable remedy, both for 
the congested portal system and the peculiar diarrhea. If 
the patient is restless and cannot sleep at night, then coffea 
will usually give relief. 

Third Stage. — When the third stage begins to develop, 
then it will require prompt action, and a nice discrimination of 
the remedies to be used. While we usually mention the 
remedies alphabetically, yet the indicated one may be the last 
on the list. 

Argenticum nitricitm. — This remedy is often needed in the 
second stage on account of the vomiting of a brownish mass, 
mixed with coffee-ground -like flakes, with green fetid stools. 

Arsenicum. — This remedy is indicated for violent vomit- 



164 THEORY AND PRACTICE OF MEDICINE. 

ingf immediately after eating or drinking-. The substances are 
brown and black. There is burning in the stomach, with 
great thirst, drinking little and often. Rapid prostration. 
Extreme restlessness and fear of death. 

Cantharis. — Has highly colored red, or bloody urine, or 
suppression of urine. Cold sweat on the hands and feet. 
Constant desire to urinate. 

Cannabis saliva has thick turbid urine, or stoppage by 
mucus. 

Car bo veg. — Is indicated for hemorrhage, and great foul- 
ness of all the excretions. Patient wants more air, and to be 
fanned all the time. 

Crotalus. — Has hemorrhages from the eyes, nose, mouth, 
stomach, and intestines. Tongue scarlet-red, or brown and 
swollen. Fetid diarrhea. 

Mcrcurius. — Is indicated not only in the second stage for 
congestion of the portal system, but at an}' stage where there 
is bloody diarrhea, followed with pain in the rectum. 

Sulphur. — Has itching and burning pain in the eyes. 
Vomiting of bilious, acid, bloody or blackish matters. Burn- 
ing on top of the head. Frequent weak, faint spells. 

Veratrum album. — Violent vomiting of green or black 
bile, with great weakness after. The stools are thin, blackish 
or yellow. Intense thirst for cold water. Excessive weak- 
ness. Pulse almost imperceptible. Cramps of the limbs, with 
cold sweat. 

Veratrum viride. — Is indicated for congestion of lung-s and 
stomach, with high fever, nausea, and vomiting ; sensation as 
though the lungs could not be fully expanded ; burning dis- 
tress in the cardiac region ; hiccough, with feeling as though 
a ball w T ere lodged in the assophagus. 

Yellow fever is very fatal to females who are . enciente. 
Uterine hemorrhages are very common. Sabma is indicated 
w T hen the blood is bright-red. If the blood is dark colored, 
with uterine pains, then secale is called for, and the patient 
must be kept cool and quiet. 



THEORY AND PRACTICE OF MEDICINE. 1 65 

riental Symptoms. — Ignatia has intense depression. 
Hyoscyamus, wild muttering delirium. Str ammonium, has 
furious mania. 

You must give china during convalescence. The diet 
should consist of milk, black tea, and beef essence. The pa- 
tient must be kept quiet during the whole course of treat- 
ment. Statistics, old school 55 per cent. ; homoeopaths 10 to 
12 per cent. 

VARIOLA or SHALL=POX, 

This is a zymotic disease of the eruptive variety of gen- 
eral or idiopathic fevers. It is contagious and sometimes epi- 
demic. It has this peculiarity, that it attacks the patient 
but once during his life-time — there is sometimes exceptions 
to this rule. The disease is characterized by a continuous 
fever of three or four days duration, when a remission takes 
place, accompanied by an eruption of the skin, which is char- 
acteristic of a contagious specific virus. The disease mani- 
fests itself in three primary forms ; and these, together with 
the modified varieties, and the pathological changes that pro- 
duce the modification, may be classified thus : 



Variola. 



Distinct, 

Confluent, 

Malignant, 

Varioloid, or Modified, 

Vaccina, or Prevention. 



Symptoms oe Distinct Smalx-Pox. — The symptoms 
of small-pox are ushered in by a chill which lasts about half 
an hour, and is followed by a high fever. The face is flushed ; 
the head and back are painful ; the eyes are red and watery ; 
the stomach is irritable with nausea and vomiting ; the appe- 
tite is impaired, and the thirst is sometimes intense. These 
symptoms continue unabated until about the close of the 
third day, or beginning of the fourth ; when an eruption 
makes its appearance, first on the face and neck. At this 



l66 THEORY AND PRACTICE OF MEDICINE. 

time there is a remission of the fever, and as the eruption 
spreads over the body, there is a further abatement of the 
symptoms until the beginning of the fifth day, when the pa- 
tient is quite comfortable, and is almost entirely free from 
fever. About the same time that the eruption makes its ap- 
pearance upon the forehead, it may be observed on the 
mucous membrane of the fauces ; and as it progresses on the 
face, it also extends from the throat to the sides of the cheeks. 
The eruption appears at first as red spots resembling flea bites, 
and they feel like little nubs under the finger — this is charac- 
teristic of small-pox, and is therefore diagnostic. The erup- 
tion passes through the stages of pimple, vesicle, pustule, and 
scab in the same order and regularity, beginning with the 
pimple on the face and extending over the whole body. The 
papular stage is completed by the middle of the fifth day. 
About the second day of the eruption the pimples upon the 
face undergo a change ; the apex is filled with clear lymph 
and become depressed in the center. They are then called 
vesicles, and are soon surrounded by an inflamed areola. The 
vesicles take the same course and follow the same order of 
progress that are observed by the papulae. They continue to 
enlarge and become pointed ; their contents increase in quan- 
tity and are changed in color, and finally become purulent. 
The vesicles are now said to be mature, and are called pus- 
tules. This maturation is accomplished about the eighth day 
of the eruption. Soon after the pustules are fully formed, 
they undergo a change ; their contents become darker ; the 
areolae begin to fade ; and by the eleventh day the pustules 
become rough, break, and dry into scabs. By the fourteenth 
day the scabs begin to fall off, and leave the skin red and in- 
dentated or pitted. The number of pustules in the distinct 
variety of small-pox are variable ; sometimes they are few, 
and at other times the whole body is thickly covered ; but 
still they are distinct. 

Having traced the eruption from its papular form through 
its various stages to the maturation of the pustule, and the 



THEORY AND PRACTICE OF MEDICINE. 1 67 

exfoliation of the scabs; we must return to the primary symp- 
toms and see what pathological changes take place in the 
system during the progress of those stages. We have already 
shown that as the eruption makes its appearance, the fever 
begins to decline ; and by the time the vesicles are fully 
formed the patient is free from fever, and feels comparatively 
well. About the seventh or eighth day of the disease, the 
patient complains of sore throat, the fauces swell, and ptyal- 
ism becomes troublesome. About the eighth or ninth day 
secondary fever sets in, and it varies in proportion to the 
amount and character of the eruption. During the formation 
of the pustules the face swells ; the mucous membranes are 
covered with the eruption ; and the eyes are so much swollen, 
that the lids are often closed, and the patient is unable to see. 
The skin becomes itchy and the patient has a propensity for 
scratching. As the pustules reach maturity and break, there 
is an intolerable odor evolved, which if once inhaled will never 
be forgotten or mistaken. When the pustules begin to dry on 
the face, those on the extremities have only reached the period 
of suppuration. The feet and legs swell and undergo the 
same change through which the face and upper portion of the 
body has already passed. 

If there is no complication in the distinct variety of small 
pox, the fever begins to decline with the formation of the 
scabs. The tongue cleans ; the appetite begins to improve ; 
and by the time that the pustules are exfoliated the patient is 
well. The duration of this variety of small-pox is from four- 
teen to twenty-one days. 

Confluent Small-Pox. — The invasion of confluent small 
pox is similar to that of the distinct. The fever is more vio- 
lent in the former, the pulse ranging from no to 120 or more 
per minute. The temperature is often 106 F., and does not 
fall so low during the remission as it does in the latter. The 
pain in the head, and lumbar region, and the gastric irritation 
are much more aggravated and annoying to the patient in com- 



1 68 THEORY AND PRACTICE OF MEDICINE. 

fluent than in the distinct. Delirium comes on sooner and is 
much more violent ; the eruption appears earlier and is thicker, 
and does not pursue that even and regular course through the 
various stages from pimple to pustule as we observe in the dis- 
tinct ; nor are the pustules so perfectly developed. The 
fauces, and mucous membrane of the mouth, are thickly 
covered with the eruptions ; and the parts become so much 
swollen as often to cause the tongue to protrude, and prevent 
deglutition, and death often takes place by suffocation. 

As the pustules mature, they run together and form a solid 
scab. The face becomes swollen ; the swelling often assumes 
the erysipelatous form and obliterates every feature. About 
the tenth or eleventh day of the disease, the scabs begin to 
turn brown, first upon the face and neck, and extend over the 
whole body in the same order in which the pustules matured. 
Beneath these scabs suppuration has been going on, and the 
face feels soft, and often fluctuates as an abscess ready for 
the lancet. If these scabs be broken there is a discharge, or 
oozing of very offensive pus. Sometimes, from the excessive 
itching, the patient breaks the pustular crust and leaves the 
parts raw, and discharging sanies and pus. 

During the eighth or ninth day, the fever, which had 
abated during the papular and vesicular stages, returns, and 
with it an aggravation of all the symptoms. As the pustules 
are maturing the fever increases, the pulse becomes quick and 
full ; the tongue becomes dry and brown ; the head is often 
painful, and the patient delirious. He is often furious and 
uncontrollable ; he feels that he is among strangers ; and he 
does not recognise his best and dearest friends. He often leaves 
his bed and walks into the streets ; and if questioned he tells 
you that he is going home. At this stage of the disease we 
are liable to have a complication with inflammation of the 
brain, or pneumonia, bronchitis, erysipelas, diarrhea, and dys- 
entery may set in with their train of symptoms, and may or 
may not compromise the life of the patient. If he escapes or 
survives these complications, there are other trials and dan- 



THEORY AND PRACTICE OF MEDICINE. 1 69 

gers through which he may be called to pass. For as the 
disease advances, and the matter from the pustules is reab- 
sorbed, a blood-poison is generated, and the patient sinks into 
a typhoid state. The pulse grows quick and feeble ; the feces 
are passed involuntarily ; the urine is retained ; the patient 
becomes comatose ; he picks at the bed-clothes or imaginary 
objects ; and death comes sooner or later to relieve him of one 
of the most loathsome diseases with which man has ever been 
afflicted. The disease does not always end in death. The 
patient may rally even from the prostrated condition to which 
I have referred, to be tormented with abscesses, boils, ophthal- 
mic inflammation, ulceration of the cornea, and loss of the 
sight of one or both eyes ; or if he escapes all of these troubles 
his convalescence is long and tedious ; and his life is a burden 
to him for many weeks. 

Malignant Small-Pox. — This is sometimes called vari- 
ola nigrse, or black small-pox, from the dark color of the 
pustules, or livid appearance of the skin. This variety dif- 
fers from ordinary small-pox only in degree. One and the 
same specific virus is the cause of all of the varieties of small- 
pox. And the difference in the types is owing either to the 
peculiar epidemic influence of the atmosphere, or the diathe- 
sis of the patient. 

If a person, who is in the aplastic diathesis, and lives in 
an unhealthy location, and sleeps in a dark, damp, and bad- 
ly ventilated room, be attacked with small-pox, it will be 
almost sure to put on that form called the malignant type. 
The symptoms at first may be similar to those of the ordinary 
distinct and confluent varieties, or even those of the modified 
form. But suddenly, before or after the eruption appears, the 
patient sinks into a low comatose condition, and dies in a few 
hours. But more generally death does not take place until 
after the seventh day. The patient is generally prostrated 
from the incipiency of the disease. A low muttering deliri- 
um is soon developed ; the gums and mucous membranes 



170 THEORY AND PRACTICE OF MEDICINE. 

early show a tendency to bleed ; the eruption is imperfectly 
matured ; the pimples look more like the spots of malignant 
ecchymosis than the red eruption of small-pox. Instead of 
the vesicles filling with the clear lymph of the other varieties, 
they are filled with a dark fluid ; and instead of passing into 
the pustular form, they look more like brown blisters. At 
this stage the pulse becomes feeble; the breathing is labor- 
ious ; the tongue is brown ; subsultus tendinum is observed, 
and the patient passes away quietly without a struggle. 

Pathology. — The pathology of this variety of small- 
pox consists in this, that the patient being in the aplastic di- 
athesis, or in that condition in which the blood is deficient in 
plastic material, susceptibility is increased and vital affinity 
is perverted. And when the specific virus of small-pox en- 
ters the system a further change takes place in the blood, by 
which the nervous centers are depressed, capillary circulation 
is retarded, decarbonization of the blood is arrested, and death 
takes place with all the symptoms of blood poisoning. 

Varioloid, or Modified Small-Pox. — Long before 
vaccination was discovered it was noticed, in almost every 
epidemic of small-pox, that there were cases of a very mild 
character. They had all the characteristics of true variola 
without the eruption ; while other cases would have a slight 
crop of pimples which would pass into the vesicular stage, 
and dry up without becoming pustular. These varieties were 
called the crystalline-pox, stone-pox, horn-pox, and wart-pox, 
according to the character of the vesicular eruption. This 
mild variety of small-pox is due to the hyperplastic diathesis, 
in which the system is scarcely susceptible to the specific 
virus ; and when it enters the blood it is surrounded by a wall 
of plastic material, and is carried out of the system through 
the skin, upon which it is localized into vesicles. These ves- 
icles dry up and scale off because the elements necessary to 
the formation of pustules, and the suppurative process are ab- 
sent from the system. For this reason the disease is modified 



THEORY AND PRACTICE OF MEDICINE. 171 

or cut short in its progress. The true varioloid is a mild case 
of variola, which is modified in its symptoms, course, and re- 
sults by a former attack, or by vaccination. 

Symptoms of Varioloid. — The symptoms of vario- 
loid are similar to those of the distinct variety of small-pox. 
The eruption shows itself as early as the third day. After 
the vesicular stage is completed, the fever abates and seldom 
returns as in the other varieties. About the fourth day the 
temperature begins to fall ; and about the sixth or seventh 
day it is nearly normal. There is no regularity as to the 
amount of the eruption. Sometimes there may be but one 
pimple found upon the face or breast ; and that passes through 
all the stages, from papula to pustule, more speedily, and dry 
up more rapidly than in the other varieties. More frequently 
the face and body are pretty thickly covered with pustules ; 
and once in awhile they may become confluent on the face. 
But they soon dry up without producing that intolerable odor, 
that accompany the other grades. Varioloid runs its course 
much sooner than the unmodified form of small-pox, and it 
is seldom complicated. When the eruptive stage is complet- 
ed, the fever abates and the patient may be said to be conva- 
lescing ; for the pimples often pass into the vesicular stage, 
and immediately dry up. Or if they do assume the pustular 
form, they pass into that stage so mildly that the patient feels 
no inconvenience, except a little cutaneous irritation. 

Causes. — The question has been fully settled in the 
minds of the medical profession that small-pox is caused by a 
specific contagious virus ; and that this virus is governed in 
its manifestations by epidemic and endemic causes. The poi- 
son may enter the system either through the mucous mem- 
branes, or the abraded cutaneous surface. 

The question has long been discussed as to what stage of 
the disease, the patient can communicate small-pox. But, 
evidence is accumulating that the disease may impart its virus 
by the effluvia arising from the patient during febrile action, 
or during the suppurating stage of the pustules ; or by the 



172 THEORY AND PRACTICE OF MEDICINE. 

variolous scabs after they have fallen from the patient. It is 
no longer doubted that the lymph of the vesicle or the dry 
scabs may attach clothing, or other fabrics, and be conveyed 
to the remotest parts of the earth, and then communicate the 
disease to the inhabitants. The clothing or fabric containing 
the virus must be well packed or excluded from the atmos- 
phere in order to retain its contagious property for any 
length of time. It loses its communicability in a short time 
when exposed to heat or pure air. It is not known how long 
it takes the atmosphere to destroy the virulency of the mor- 
bific agent of small-pox, when that agent is contained either 
in the lymph of the vesicle, or in the dry scab. 

The effluvia, which arises from the patient, is as conta- 
gious as either of the others ; but so soon as it is mixed with 
a certain amount of pure air it is rendered harmless. A phy- 
sician may remain in the sick room until his hair and cloth- 
ing are filled with the exhalations from the patient; and after 
walking ten minutes in the open air, he is not capable of com- 
municating the virus to others. But if he should get any of 
the matter from the pustules on his clothing, it would take 
several hours in the open air to destroy its communicability. 

As I have already intimated, the question is often asked at 
what time is the patient, with small pox, capable of communi- 
cating the disease to others? I answer unhesitatingly from 
the time that the fever is developed until the patient is freed 
from the last scab, and his body is washed and his clothing is 
changed. The period at which small-pox is developed from 
the time of exposure may be stated at from five to twenty-one 
days, as exceptions to the rule ; but from seven to nine days 
is the average duration. 

The disease is not apt to attack a person the second 
time ; but if it does so, the case runs a mild course and is free 
from danger. 

There is but little known as to the modus operandi of 
small-pox virus in the system. But there is no doubt that the 
virus is an organic zymotic agent which produces a fermenta- 



THEORY AND PRACTICE OF MEDICINE. 1 73 

tive process in the system, by which the fluids of the body are 
all leavened, and the same characteristics are developed that 
were observed in the former disease from which the virus was 
derived. 

There seems to be no difference in the communicability of 
the virus ; for the confluent may generate the distinct or modi- 
fied form ; while they, in turn, may produce the malignant. 
That is to say, there is no difference in the malignancy of the 
virus ; but that its activity or virulency depends upon the 
diathesis of the patient, or the epidemic influence of the atmos- 
phere, or the sanitary condition of the place. 

Morbid Anatomy. — But little may be said about the 
pathological changes in small-pox. The only characteristic 
appearance is the eruption on the skin and mucous membrane. 
If death occurs it takes place either by some inflammatory 
process, or a typhoid condition of the system. If from the 
former the pathology of inflammation will be manifest and 
give the same evidences of inflammatory action in the organs 
as from ordinary causes. But if death takes place from a 
typhoid condition induced by the disease, the solids and fluids 
will indicate the degree of malignancy of the disease. 

Diagnosis. — The diagnosis of small-pox is sometimes 
difficult in the early stage. But the intense pain in the back, 
irritability of the stomach, and a quick full pulse, are symp- 
toms that may lead us to suspect small-pox — especially if the 
disease is prevailing at the time. If, about the third or fourth 
day, an eruption makes its appearance upon the face, we may 
feel pretty sure that the case is one of variola. And if the 
eruption feels hard under the finger like little nubs or shot 
there need be no further doubt as to the character of the dis- 
ease — it is diagnostic of small-pox. 

The distinction between the varieties of variola is to be 
observed in the character of the eruption. Varioloid can ■ 
only be diagnosed by the sparseness of the eruption. But 
when the vesicles are numerous, it is difficult to distinguish 
between it and distinct small-pox in the early stage. But in 



174 THEORY AND PRACTICE OF MEDICINE. 

varioloid the symptoms are milder ; the fever subsides earlier, 
and the eruption hardly ever runs the regular course as they 
do in the distinct. 

Prognosis. — The prognosis of small-pox must be grave 
or otherwise in accordance with the type of the disease. In 
distinct small-pox the cases generally recover with proper 
treatment and hygienic regulations. The confluent has been 
quite a fatal disease ; but many cases recover with the im- 
provement in modern treatment. The malignant type is very 
fatal — recoveries being the exception to the rule. Varioloid 
is never fatal except when it attacks an already shattered 
constitution. 

There are certain symptoms and conditions by which we 
are enabled to guard our prognosis. The appearance of the 
rash at the stated time ; its regular course from pimple to pus- 
tule ; the remission of the fever at the approach of the erup- 
tion ; and the mildness of the secondary fever ; moderate 
swelling of the face and feet ; the moist tongue ; mildness of 
the cerebral wanderings, are all favorable prognostic symptoms. 
But, on the other hand, a rapid pulse ; irregularity in the 
stages of the eruption ; comatose condition with a dark, dry 
tongue ; sordes around the teeth ; and any organic complica- 
tions, are unfavorable symptoms. And, finally, in all malig- 
nant cases the prognosis is unfavorable from the beginning. 

From the statements of various authors it appears that the 
average period of mortality in hospital practice is about the 
eighth day, and in private practice between the twelfth and 
eighteenth day. 

Treatment. — Primary fever requires either aconite, bel- 
ladonna, or veratrum viride. You remember the distinguish- 
ing characteristics of each of the fever remedies. In the 
mild cases aconite, antimoninm tartaricum, and sulphur are 
the only remedies required. Aconite for the febrile stage, anti- 
moninm for the eruptive stage, and sulphur during desquama- 
tion, to prevent after effects. These three remedies are 
strictly homoeopathic in a majority of cases. But as we meet 



THEORY AND PRACTICE OE MEDICINE. 1 75 

with various types of the disease we have other remedies to 
meet each indication. As Ruddock has laid down concise 
rules for each stage and condition I will repeat what he says. 

Eruptive Stage. — Antimonium tart., thuja, sarracenia, 
sulphur. 

Suppurative Stage. — Antimonium tart., merairius, apis, 
lachesis. 

Retrocession of Eruption. — Camphor, sulphur. 

Confluent and Malignant Cases. — Sulphur, arsen- 
icum, phosphorus. 

Complications. — Phosphorus, antimonium tart., for pneu- 
monia ; aconite, bryonia, for congestion of the lungs ; bryonia, 
kalibich., antimonium tart., for bronchitis ; rhus tox., for severe 
pain in the back ; mercurius, for glandular swellings ; apis, 
belladonna, for dropsical swellings, closed eyes, and swollen 
throat ; belladonna, hyoscyamus, strammonium, veratrum vir- 
ide, for delirium ; arsenicum, baptisia, for sudden prostration 
and threatened syncope. 

To Prevent Pitting. — Sarracenia ; also picking the 
pustules on the face with a needle after dipping it in carbolic 
acid. Cover the face to exclude the atmosphere. 

Desquamation. — Sulphur, with frequent tepid sponging, 
and strict cleanliness. 

SEQUELAE. — Sulphur mercuris cor., ophthalmia; hepar 
sulphur, phosphorus, sulphur, for boils. 

Prophylactics. — Vaccination, sulphur, vaccinin y thuja, 
antimonium tart. 

Apis. — This remedy is indicated where there are erysipe- 
latous redness and swelling, and stinging pain, it matters not 
where located and in what stage of the disease it occurs. One 
of the grand characteristics of apis is a tight feeling in the 
abdomen as though something would break. 

Antimonium tartaricum. — This agent will produce an erup- 
tion on the skin, and pass through the various stages as that 
of small-pox. In addition to this it is also valuable in the 
primary fever if nausea and vomiting occur. 



176 THEORY AND PRACTICE OF MEDICINE. 

Camphor. — Sudden desiccation of the pustules and disap- 
pearance of the swelling. Extreme prostration and sinking of 
the forces. Great coldness of the skin, but cannot bear to be 
covered. 

Opium. — Do not forget that in any disease, when the pa- 
tient is drowsy, with stertorous breathing, then opium is the 
first remedy to be thought of. 

Rhus tox. — When typhoid symptoms supervene in variola 
then rhus tox., is an invaluable remedy. The tongue is dry 
and cracked, corners of the mouth sore and ulcerated. 

Sarracenia. — There has been no proving of this agent that 
I am aware of, but it would appear from some clinical experi- 
ments that it modifies the course of the disease, and lessens 
the chances of pitting. 

Sulphur. — Teste says : When the disease pursues an 
irregular course ; when the eruption exhibits a tendency to 
disappear from the surface ; when the pustules, instead of being 
transparent or yellow, are green, purple, or black ; when the 
blood with which they are filled announces a decomposition of 
this fluid, it is not to arsenicum that we should have recourse, 
but to sulphur. 

Vaccinin and variolin have been highly extolled as reme- 
dies in this disease. It is said, by those who have used them 
extensively, that all stages of the malady are shortened, and 
the disease rendered mild and harmless. They promote sup- 
puration and exsiccation, and prevent all scars. 

It is reported that Jenner failed in vaccinating thirty sol- 
diers when they were receiving sulphur treatment ; subse- 
quently all the men took the genuine cow-pox. This being 
true then we must infer that sulphur is a prophylactic against 
small-pox. But I imagine that to be able to ward off the 
virus of small-pox that the system must be brought under the 
influence of crude sulphur. 

Patients with small-pox should be kept comfortably warm, 
but free from direct draught. The room should be well ven- 
tilated, and kept clean. Never allow your patients to have 



THEORY AND PRACTICE OF MEDICINE. 1JJ 

warm drinks, but let them drink cold water in moderation. 
The diet must be milk, soft eggs, and beef essence. You must 
remember that your patient is in the aplastic diathesis and re- 
quires animal food to increase the plasticity of the blood. 

After the pustules burst they may be powdered with starch 
or baked clay. The clay is a disinfectant, and is very sooth- 
ing to the patient. I have never tried it, but I am inclined to 
think that if the pustules were covered with powdered clay so 
as to exclude the atmosphere, it would prevent pitting. 

The patient should never leave his room until the scabs 
are all off his body, and then his whole body must be washed 
in warm water and soap, and attired in clean clothing, before 
he receives company or mingles in society. 

All bedding and clothing used in the patient's room should 
be burned if they cannot be washed. If they can be washed 
then they should be immersed in hot water and raised to a 
temperature of 212 . The paper should be taken off the 
walls, the floor scrubbed, and then close all windows, doors 
and apertures after burning sulphur has been placed in the 
room. Sulphur is supposed to kill the bacteria or microbes. 

nT«?lTA«5V PERIOD OF ERUPTION APPEARS. ERUPTION FADES. 



INCUBATION. 



f Scabs form 9th 

Small-Pox. ... 12 days. 3rd dav of fever. J ° r Ioth /*? °j 

) fever, and fall off 

(^ about the 14th. 

Measles 10 to 14 days. 4th day of fever. 7th day of fever. 

Scarlet Fever, 4 to 6 days. 2nd day of fever. 5th day of fever. 

RUBEOLA or MEASLES. 

This disease belongs to the eruptive type of continued 
fevers, and is contagious. Both children and adults are sub- 
jects of the disease. 

Symptoms. — Measles begin with catarrhal symptoms, 
eyes red and watery, sneezing with a watery discharge from 
the nose. Fever sets in, followed by a hoarse croupy cough, 
face becomes swollen, tongue becomes dry, the throat is red 



I78 THEORY AND PRACTICE OF MEDICINE. 

and tender. On the fourth day of the fever the eruption 
makes its appearance on the forehead and face, then on the 
neck and soon covers the whole body. Even before the fourth 
day the eruption may be seen in the fauces. The fever in- 
creases until the rash is well out, and in favorable cases it 
begins to abate. If the rash is abundant it is more favorable, 
and if it remains out three days there is no danger of retro- 
cession. The eruption has a reddish, rough-looking appear- 
ance. The average temperature is about 103 °, but much 
lower in mild cases. In ordinary cases the temperature 
reaches its acme on or about the fourth day. There is more 
or less bronchial trouble as the disease advances. The in- 
flammation sometimes extends to the substance of the lungs, 
and produces pneumonia ; or to the ramifications of the bron- 
chial tubes, producing capillary bronchitis. The period of 
incubation is from ten to fourteen days. I, however, once 
knew a case developed on the thirty-seventh day after expo- 
sure to the virus of measles. 

Diagnosis. — The diseases which sometimes may simu- 
late measles, are roseola and scarlet fever. The eruption is 
very much alike, but in roseola there are no catarrhal symp- 
toms. The strawberry tongue is wanting in measles, which 
is so characteristic in scarlet fever. 

MEASLES. SCARLET FEVER. 

i . Catarrhal symptoms are prom- 1 . Catarrhal symptoms are usual- 

inent — watery discharge from ly absent, but there is great 

the eyes and nose, sneezing, heat of the skin, sore throat, 

harsh cough, &c. and sometimes delirium. 

2. The rash is of a pinkish-red, 2. The eruption is of a bright 

or raspberry color. The scarlet color, and by draw- 
white streak produced by ing the back of the nail over 
the back of the nail is not the skin a white streak is 
uniform, and lasts a shorter produced, which lasts two 
time than in scarlet fever. or three minutes. 

3. The eruption somewhat rough, 3. The rash usually presents no 

so as to be felt by passing inequalities to sight or touch, 

the hand over the skin, and and is so minute and closely 

is in groups of an eccentric crowded as to give the skin 

form. a uniformly red appearance. 



THEORY AND PRACTICE OF MEDICINE. 1 79 

4. Liquid, tender, watery eye. 4. A peculiar brilliant stare, as if 

the eyes were glistened by an 
etherial lustre. 

5. The cuticle is thrown off in 5. Desquamation of the cuticle is 

minute portions, like scales in large patches, especially 

of fine bran. from the hands and feet. 

6. The most common sequelae are 6. The most frequent sequelae are 

diseases of the lungs, eyes, dropsy, especially after mild 

ears, and skin. cases, and glandular swell- 

ings. 

7. The eruption appears on the 7. Eruption on second day of 

fourth day of fever. fever. 

Prognosis. — The prognosis of this disease is generally- 
favorable in sporadic and uncomplicated cases. But in com- 
plicated cases, and in certain forms of epidemics, it sometimes 
proves a fatal disease. The most dangerous complications are 
pneumonia, bronchitis, laryngitis, and the aplastic diathesis. 
In the aplastic diathesis the rash has a dark unhealthy appear- 
ance, and in the lowest grade of that diathesis the eruption 
turns dark, thus showing that the disease has assumed the 
malignant form called by some black measles. There is no 
separate disease of measles by that name, but one and the same 
virus acting on the aplastic diathesis makes the difference. 

Treatment. — In the mild uncomplicated cases of mea- 
sles you will require but three remedies. I. Aconite for fever 
and catarrhal symptoms. 2. Pitlsatilla is almost specific. If 
aconite is not indicated by intense thirst, or if it makes no 
change in the catarrhal symptoms within twenty-four hours, 
then you must look to Pulsatilla. It is indicated by red watery 
eyes, and intolerance to light. There is a thick, greenish or 
yellowish discharge. (Aconite has thin watery discharge with 
sneezing). Pulsatilla has dryness of the mouth without thirst. 
The eruption is tardy in coming out. Cough worse towards 
night and during the night. There may be nightly diarrhea. 
Craves cool, fresh air, worse in a warm room. 

Cases are on record where the disease, having been sup- 
pressed, was followed by troublesome sequelae of different 



l8o THEORY AND PRACTICE OF MEDICINE. 

kinds which lasted for months ; when Pulsatilla was given, 
the exanthema reappeared, ran its course, and the patients 
lost their secondary disorders. 

3. Euphrasia is indicated by copious watery discharge 
from the eyes and nose. Sometimes the eyes are quite red, 
sore, and painful. In that case I have found the following 
wash very soothing. Tincture calendula ten drops ; hamame- 
lis virginica, distilled, ten drops ; water one ounce ; mix and 
wash eyes three times a day. 

The foregoing treatment is generally sufficient for the 
simple variety of measles. But owing to the epidemic in- 
fluence of diathesis in certain communities, you may have 
mild or grave complications, which must be speedily met or 
serious trouble may supervene. I need not refer to those 
complications in particular, for, as I point out the grand char- 
acteristics of the remedies, you will readily perceive what the 
pathological conditions are which call for those agencies. 

Apis. — Confluent eruption and ©edematous swelling of the 
skin. Cough and soreness in the chest as if bruised. Oppres- 
sion of the chest, with inability to remain in a warm room. 
Scanty and highly-colored urine. Diarrhea in the morning, 
stools greenish-yellow. 

Arsenicum. — Typhoid symptoms ; burning and great dry- 
ness and itching of the skin ; the eruption disappears too sud- 
enly ; constant craving for cold water, drinking often but lit- 
tle at a time ; rapid prostration. 

Belladonna. — Sore throat, dry spasmodic cough. Starting 
and jumping during sleep, with flushed face and red eyes. 

Bryonia. — Congestion of the chest, stitching pains while 
moving. Great dyspnoea and quick breathing. Nausea and 
a faint feeling when rising. Thirst for large draughts of water 
at long intervals. 

Antimonium tartaricum. — This remedy is indicated for 
loose rattling cough. 

Camphor. — For depression of the vital forces. Face pale, 
and the skin cold, assuming a bluish tint. The eruption is 



THEORY AND PRACTICE OF MEDICINE. l8l 

slow in its appearance and is irregular in its stages. Camphor 
has this peculiarity, the skin is cold, and yet the patient will 
not be covered. 

Coffea. — Is indicated where there is extreme restlessness 
and wakefulness. 

Ipecac. — Is called for where there is suppression of the 
eruption and constant nausea. 

Mercurius. — Must be given where there are glandular 
swellings. Soreness of the throat, with ulcers on the tonsils, 
and flow of saliva. Diarrhea, with green, slimy, or bloody 
stools, with severe tenesmus. 

Gelsemium. — If the eruption is slow in making its appear- 
ance, or having appeared, and suddenly recedes, and if there 
are symptoms of convulsions, then gelsemium is your main 
remedy. 

Phosphorus. — Is indicated for violent coughing with brick- 
dust sputa. Pain in left side is of frequent occurrence. The 
patient is often hoarse, with loss of voice. Sometimes there 
is a hoarse croupy cough, which is very harrassing and calls 
for the use of spongia. If the croupy cough is accompanied 
with expectoration of a stringy phlegm, then kali bichromicum 
must be called into requisition. 

Sequelse. — Measles almost always leaves some complica- 
tion in its train. The lungs, eyes, ears and skin, are the parts 
usually affected. If there is a tubercular diathesis lurking in 
the measles patient, it is likely to be called into action. So if 
you are aware of that fact you should give your patient special 
care, to see that the eruption is plentiful, and kept out at least 
two days, and longer if possible. The patient must have fresh 
air without a direct draught. If the eruption recedes suddenly,, 
then the patient should be put into a warm bath for a few 
minutes, wiped dry and rolled in warm blankets. At the same 
time giving the indicated remedy. 

I wish to urge the fact upon you to never let vour patients 
have warm drinks of any kind, nor stimulants, for thev only 



l82 THEORY AND PRACTICE OE MEDICINE. 

increase the febrile excitement, and thus endanger the life of 
your patient. I allow my patients cold water as often as they 
call for it, and why ? Simply because it is refreshing ; it 
moderates the fever, and thus lessens the chances of inflam- 
mation, and above all, cold water brings the eruption to the 
surface more readily than any other means. The philosophy 
of cold water internally is this, the mucous membrane of the 
alimentary tract is full of the eruption, and by cooling the 
stomach with cold water the eruption is forced to the cutane- 
ous surface. This is illustrated by the fact that if you take a 
pitcher in a very hot day and fill it with water containing a 
piece of ice, in a short time you will notice drops of water 
standing on the outside of the pitcher. The pores of the 
pitcher were filled with caloric, the ice coming in contact with 
the sides of the pitcher forced the heat to the external surface 
and vaporized it, and finally condensed it into drops of water 
on the sides of the pitcher. 

I remember, when I was ignorant of homoeopathy, and 
had uncertain means to force the delayed eruption, and 
the patient seemed to be consumed with fever, and the erup- 
tion only made a slight appearance, I determined to give my 
patient ice-cold lemonade. I allowed her to drink half a gob- 
let at once, and if the rash was not out in half an hour to 
repeat the dose. After the first drink I ventilated her room, 
covered her with a blanket, and in half an hour she was 
sleeping quietly and the whole body was covered with a fully 
developed eruption. I gave her no more medicine, but let 
her have the cold lemonade when she called for it, and she 
made a speedy recovery. 

The patient should be confined to a light diet, and gradu- 
ally return to solid food after the eruption has disappeared. 
The patient should avoid taking cold, because the sequelae 
are always troublesome. The bedroom should be free from 
sunlight until the inflammatory condition of the eyes has 
disappeared, and then the light may be gradually increased. 

Sulphur is a good remedy to give during convalescence. 



THEORY AND PRACTICE OF MEDICINE. 183 

SCARLATINA or SCARLET FEVER. 

The idiopathic eruptive disease known as scarlet fever, is 
characterized by a fine red rash covering the cutaneous sur- 
face ; and is accompanied with sore throat. The throat 
affection is a local manifestation of the general character of 
the disease, and is therefore an index of the pathological 
change that is going on in the animal economy. By the dif- 
ferent degrees of inflammatory action that are observed in the 
fauces, and the character of the general symptoms that ac- 
company those changes in the throat, we have three varieties 
of scarlet fever. They are thus classified : 

f Scarlatina Simplex, 
scarlet fever. < Scarlatina Anginosa, 
[^ Scarlatina Maligna. 

I remark that this classification is arbitrary, and only 
shows the different grades of the same disease. There are 
general pathognomonic symptoms that are common to all of 
these varieties ; and it is only a difference in the diathesis of 
the patient, or the epidemic influence that makes the differ- 
ence in the three grades of the disease. 

I will first take up the clinical history and symptoms of 
the simple variety of scarlet fever, and afterwards notice the 
differential character of the other two grades. 

Scarlatina Simplex. — Scarlet fever is ushered in by 
the premonitory symptoms that usually accompany exan- 
thematous diseases in general. The patient feels a little in- 
disposed for a short time, with some pains in the back and 
limbs. There is usually a slight chill followed by fever ; the 
pulse is quick, the skin is hot and dry, the face is flushed ; 
nausea and vomiting is almost always present in children ; 
and the throat looks a little inflamed, with some tenderness 
in swallowing. As the fever increases the temperature rises, 
and about the second day of the fever a red rash makes its ap- 



184 THEORY AND PRACTICE OF MEDICINE. 

pearance, first upon the face, neck, and breast, and spreads to 
ever\* portion of the body. The rash is of a peculiar redness, 
and has been compared to the color of a boiled lobster. The 
eruption in this variety is more diffused, and it is of a brighter 
color than in either of the other varieties. The simple vari- 
ety of scarlet fever is characterized by the absence of sore 
throat, or if it be present it is of a very mild character. There 
is a diversity of grades in this variety of the disease. Some- 
times we have fever and sore throat without the rash ; at 
other times we have the rash with but little fever and no sore 
throat. The patient often continues about his room, and is 
never sick enough, to q-o to bed. But. more generally, the 
fever lasts for four or five days with considerable severity. 

The rash begins to fade with the decline of the fever, and 
desquamation takes place. Sometimes the cuticle of the whole 
body scales off — especially the palms of the hands and soles of 
the feet. During the period of desquamation the skin is itchy, 
and sometimes irritable. At the end of the fourteenth day the 
stage of desquamation is usually completed, and the patient 
may be said to be convalescent. But he is to be carefully 
watched for some time after this period : for he is still liable 
to relapses, or to attacks of the sequelae to which I will refer 
hereafter. 

Having given the clinical history and some of the most 
prominent symptoms of the simple variety of scarlet fever, I 
now call vour attention to a much more grave character of the 
disease, which has been called 

Scarletixa Axgixosa. — This variety of scarlet fever is 
accompanied, in its incipiency, with ail the symptoms of the 
simple variety, except that the throat symptoms are more early 
marked. The patient complains of pain and difficulty in 
swallowing at the time, or soon after the fever is developed. 
The jaws are stiff, the tonsils are swollen, and they are of a 
deep red color : and as the disease advances they become 
covered with an ash-colored exudation, either in patches or 



THEORY AND PRACTICE OF MEDICINE. 1 85 

diffused. The disease spreads to the nares, producing a stuff- 
ing of the nose with an acrid secretion, the submaxillary and 
parotid glands swell and often suppurate, and leave discharg- 
ing ulcers. The pulse is quick, often 120 to 130 per minute, 
in children, the skin is hot and dry ; the temperature ranging 
from 105 ° to 106 F. The tongue has a peculiar red appear- 
ance with the papillae elevated. To this condition the term 
strawberry tongue has been applied because it resembles a 
red strawberry. 

As the disease advances the discharge of saliva and sanies 
from the mouth and throat become very offensive. The 
patient becomes feeble, delirium sets in ; he becomes restless, 
and sinks from prostration. But, more generally, the patient 
dies from suffocation induced by the diseased condition of the 
pharynx, and extension of the disease to the larynx and 
trachea. If the patient survives the ravages of the disease he 
is often left in a wretched condition. He may become deaf in 
one or both ears, and his voice is often so affected that he is 
unable to articulate distinctly ever afterwards. I am glad, 
however, to say that this once terrible scourge of the infantile 
race is now (thanks to homoeopathy) in a measure under the 
control of the physican, and a large majority of the cases re- 
cover if treated in time. 

It is sad to contemplate that there is still another variety 
of scarlet fever that often bids defiance to our best efforts. We 
refer to malignant scarlet fever, or scarlatina maligna, 

Scarlatina Maligna. — -This is the name of that variety 
of scarlet fever which assumes a low typhoid or malignant 
type from the beginning, or soon after the fever is developed. 
The pulse is generally quick and feeble ; the tongue is brown 
and fissured, the throat is of a darkish or purplish tint ; the 
tonsils are covered with an exudation of a brownish color ; 
sordes gather around the teeth ; the gums bleed at the slightest 
touch and the breath is offensive, thus showing the septic con- 
dition of the blood. Diarrhea is often troublesome from the 



l86 THEORY AND PRACTICE OF MEDICINE. 

beginning of the febrile stage, and as the disease advances the 
stools are passed involuntarily ; the pulse becomes quick and 
fluttering ; the skin is bathed with a clammy sweat, and the 
patient dies in from six to fourteen days. In some epidemics 
patients, who are in the aplastic diathesis, are stricken down 
in from thirty to forty-eight hours after the fever is developed. 
They die from prostration of the organic functions. The rash 
in this variety of scarlet fever is later in making its appear- 
ance than in either of the others, and instead of its pursuing 
the usual course, as in the other forms, it often assumes the 
character of ecchymosis ; that is, looks like a bruise. 

Sequelae. — Some of the most obstinate and distressing 
features of scarlet fever are the sequelae that often follow in 
its train. Inflammation, suppuration, and ulceration of the 
internal ear is of frequent occurrence in the anginose and 
malignant types of this disease. If this condition is not 
speedily arrested, perforation of the tympanum and permanent 
deafness will be the result. Abscesses are liable to occur in 
any portion of the body, but more generally the parotid and 
submaxillary glands are the seat of abscess and ulceration ; or 
the glands may be left tumefied for several months after the 
patient is apparently well. The joints are often left swollen 
and painful. Dropsy is, perhaps, the most dangerous sequelae 
with which we have to contend, and it makes its approach in 
a quiet and unsuspecting manner. 

I once had a little patient who passed through a very se- 
vere attack of the anginose variety, and apparently regained 
her usual health ; but two weeks after she had been able to 
go to school, it was noticed that she became short of breath 
by exercising. Upon examination I found a collection of 
water in the thorax, producing what is called hydrothorax. 
But more generally we have anasarca. Sometimes we have 
ascites, hydropericardium, and hydrocephalus. In the differ- 
ent forms of dropsy the renal functions are generally at fault 

Cause. — The cause of scarlet fever, like the other exan- 
thematous diseases, is produced by a zymotic specific virus. 



THEORY AND PRACTICE OF MEDICINE. 1 87 

The disease prevails epidemically and endemically. The vir- 
ulency of the disease depends upon two causes, viz.: the char- 
acter of the epidemic influence and diathesis of the patient. 

Scarlet fever generally attacks children under ten years of 
age. But it may attack any age. As a rule a person has the 
disease but once during his natural life ; yet there are ex- 
ceptions to the rule. 

Diagnosis. — It is sometimes difficult in the early stages 
to distinguish between the premonitory symptoms of scarlet 
fever and the other eruptive fevers. But the peculiar redness 
of the throat, frequent vomitings, and the condition of the 
pulse, are symptoms that may lead us to suspect the character 
of the trouble. There is a peculiar quick, sharp beat of the 
pulse in scarlet fever that is a diagnostic sign to the trained 
finger, and which early arouses suspicion in the mind of the 
practitioner as to the nature of the disease. It is, however, 
only when the eruption appears that we can give a positive 
diagnosis. 

The fine red rash of scarlet fever is readily recognized 
from that of the rough-like patches of the eruption of measles 
by any one who has ever compared the two diseases. And 
then again the eruption of scarlet fever appears on the second 
day of the fever ; while in measles the rash does not appear 
until the fourth day. The strawberry tongue of scarlet fever 
is wanting in measles. Roseola has a finer rash than measles, 
but not nearly so fine as scarlet fever, and the fever is much less 
than in either of the other diseases ; and then, again, roseola 
has but little or no sore throat. 

The principal diagnostic feature of the three varieties of 
scarlet fever are to be found in the character of the throat 
affection and the early prostration of the system. Scarlatina 
simplex has a bright red throat with but little or no exuda- 
tion. The scarlatina anginosa has ash-colored patches on the 
tonsils ; while the exudation of the malignant type is dark, 
and the rash is of a darker tint. 



1 88 THEORY AND PRACTICE OF MEDICINE. 

Prognosis. — The prognosis of the simple variety is 
almost always favorable. Yet some of the worst forms of 
sequelae often follow this variety unless carefully watched. 
The urine should be examined, every day by the mother or 
nurse, and if it becomes scanty or highly colored, then is the 
time to prevent dropsy by appropriate treatment ; whereas, if 
this precaution is not taken, and the feet, hands, face, and 
abdomen begin to swell, then it may be too late to rescue your 
patient from the grave. 

The anginose variety must be prognosticated in accordance 
w r ith the character of the epidemic, and the sanitary condition 
of the patient. It is sometimes a most dangerous disease dur- 
ing some epidemics. Its danger lies in the fact that the patient 
may die from suffocation owing to the swelling of the neck and 
throat. But with proper treatment and sanitary regulations a 
large majority of the cases recover. 

The malignant type, as its name implies, is sometimes a 
most fatal disease among children. It often passes from house 
to house, and every child of ten years and under becomes its 
victim The only exception to this rule is where certain 
members of the family are in the plastic or hyperplastic diath- 
esis, and are therefore able to ward off the virulency of the 
disease, or its epidemic influence. This is the reason why some 
families escape the disease, while others, less favored, readily 
succumb to its ravages. 

Treatment. — Our object must be to lessen the fever, 
neutralize the poison, change the diathesis, repair the damage 
already done to the organic functions, and restore tonicity and 
vital affinity to the system. 

Some years ago when the microscopists found bacteria 
in scarlet fever patients, it was published to the world that 
Hahnemann's theory must fall to the ground, because it was 
shown that the cause of scarlet fever was a living animalcule, 
and hence his 30th potency of belladonna could not destroy 
the germ of the disease ; and hence, Mr. Hahnemann was mis- 



THEORY AND PRACTICE OF MEDICINE. 1 89 

taken in his law of cure ; for belladonna could not produce nor 
kill the bacteria. Nevertheless, homoeopaths have cured thous- 
ands of cases with belladonna alone. The question arises does 
the bacteria cause scarlet fever, or does the disease produce 
the bacteria. I would like to see a bacterium taken from a 
patient before the disease "was developed, or if we could find 
the bacillus attached to the air-passages, or in the drink of the 
patient, then we could have some data upon which to predi- 
cate a theory. But, in the meantime, while scientists are dis- 
cussing the shape and size of the animal, homceopathists 
everywhere are curing simple scarlet fever with belladonna in 
accordance with the law of cure. Hence, " similia similibus 
curantur" still maintains its ground, because it is a fixed law 
of nature. 

Treatment of Simple Scarlet Fever. — As a rule 
this type requires nothing but belladonna^ when the eruption 
is smooth and of a scarlet-red. If the throat is quite sore, a 
few doses of the biniodide of mercury may be given. The 
patient may be allowed cold water, and if the body is hot he 
may be sponged with cool water in the early stage of the fever, 
and when the time arrives for the rash to appear, and it seems 
slow about coming out, or if it recedes too soon, then the 
patient may have a warm bath, or wrapped in blankets dipped 
in warm water. If belladonna fails to arrest the fever in time, 
then you can resort to aconite if the symptoms demand it. 

As the disease begins to decline sulphur is a good remedy 
to assist nature in restoring the organs and tissues to their 
normal functions, and thus avoid, in a measure, the sequelae. 

Arsenicum is supposed to act favorably during the period 
of desquamation. When the rash makes its appearance the 
skin itches and burns, and thus makes the patient nervous 
and restless. In that condition the whole body should be 
greased with old bacon as often as necessary to quiet him. 
The salty bacon not only relieves the itching and burning, 
but also prevents the patient from taking cold. The kidneys 



J90 THEORY AND PRACTICE OF MEDICINE. 

must be watched for two or three weeks after convalescence 
so as to detect any abnormal action, and thus by timely treat- 
ment to ward off dropsy. The diet should be nourishing but 
unirritating. Pure milk is the best nourishment any patient 
can have in almost every condition. But it is only in ty- 
phoid fever and inflammation of the stomach and bowels that 
you withhold solid food in small quantities from your patients. 

Treatment of Scarlatina Anginosa. — In this vari- 
ety you must make a judicious selection of your remedies, for 
you have no time to lose in guessing. If there is no special 
indication for aconite, I begin my treatment with belladonna 
and biniodide of mei'cury, and keep them up unless some new 
symptoms develop. I have had such uniform success with 
those remedies, that it almost becomes second nature to pre- 
scribe them. You will remember that the indications for 
belladonna are a bright red throat, red staring eyes, with more 
or less head symptoms. The indications for biniodide of mer- 
cury are ulceration of the tonsils, or the fauces are covered 
with an ash-colored exudation, with a pinkish tint surround- 
ing the patches of exuded lymph. 

After giving the remedies I have mentioned a fair trial, 
then you must be prepared to meet all symptoms as they 
arise, and in order to assist you I mention a few remedies 
with their grand characteristics. 

Apis. — Has great swelling of the throat ; the nose dis- 
charges a thick, white, fetid, or bloody mucus ; ulcerated 
throat ; abdomen sore to the touch ; child lies in a stupor. 

Arum ti'iphyllum. — Corners of mouth and lips sore and 
cracked ; putrid sore throat. 

Cantharis is indicated when the throat is swollen and 
burning as if on fire ; pain in the region of the kidneys with 
scanty urination. 

Camphor. — Sudden retrocession of the eruption ; ex- 
tremities cold and purple ; hot perspiration on the forehead, 
but patient refuses to be covered. 



THEORY AND PRACTICE OF MEDICINE. 191 

Hyoscyamus. — Great restlessness, screaming, and convul- 
sions. 

Opium. — Head symptoms, with coma. 
Strammonium. — Delirium with muscular jerkings. 
Zinc is indicated for cerebral paralysis. 

Treatment of Scarlatina Maligna.— In all of the 
grades of scarlet fever you must select your fever remedy in 
accordance with the symptoms present. In the malignant 
type, however, you have but little time to lose, and hence you 
must meet the grave symptoms at once irrespective of the 
fever. Ailanthus is one of the best selections we can make. 
It has small, rapid pulse ; severe headache, with hot, red face ; 
skin covered with a miliary rash, with efflorescence between 
the points of a dark, livid color, (smooth, bright-red. -Bell.) 
The livid color, when pressed out with the finger, returns very 
slowly, (Bell, very quickly). Violent vomiting. 

Arsenicum. — This is indicated where the eruption grows 
suddenly pale, with rapid prostration ; putrid sore throat, in- 
ternal heat, with external coldness ; fetid diarrhea. 

Arum triphyllum. — Corners of the mouth and lips sore 
and cracked ; putrid sore throat ; nose stopped up, or dis- 
charging a burning ichorous fluid, excoriating the nostrils and 
upper lip. 

Bryonia is indicated when the eruption does not come 
out fully, or suddenly disappears, and when the chest becomes 
involved ; patient wants to lie perfect^ still. 

Camphor. — In desperate cases ; extremities cold and purple. 

Coffea. — When patient is restless and cannot sleep coffea 
is your main stay. 

Cuprum acetate. — Is indicated when metastasis to the brain 
is apprehended, or the eruption suddenly disappears, followed 
by convulsions and vomiting. Sopor and delirium. 

Gelsemium. — This is an excellent remedy for fever, brain 
symptoms, nervousness, to bring out the rash, and where there 
is a tendency of a remittent character. 



192 THEORY AND PRACTICE OF MEDICINE. 

Ipecac. — Constant nansea and vomiting of green, bilious or 
slimy matter. 

Lachesis. — Diphtheritic inflammation of the throat, with 
great difficulty in swallowing ; external throat swollen and 
very painful to the touch. 

Muriatic acid. — Is indicated where the throat and tonsils 
are swollen, and covered with dark colored ulcers ; great ten- 
dency for the sloughs to extend and run together ; discharge 
of thin, acrid pus from the nose, excoriating the parts ; slid- 
ing- down in the bed. 

Nitric acid. — Putrid-smelling breath ; mouth full of fetid 
ulcers ; swelling of the parotid and submaxillary glands ; 
ulceration of the corners of the mouth and lips. 

Opium. — Extreme drowsiness, stertorous breathing and 
vomiting ; delirious talking, with eyes wide open, face red and 
puffed up, impending paralysis of the brain. 

Rhus tox. — Dark colored rash and itches violently ; pain 
in the limbs and joints ; ichorous or yellow, thick discharge 
from the nose ; constantly changing position. 

Sulphur. — This remedy should be given during the decline 
of the eruption to ward of sequelae. 

Zi?ic. — Threatening paralysis of the brain ; jerking of the 
whole body, or twitching of single limbs ; grating of the teeth, 
and shrill cries, frightful dreams during sleep ; icy coldness of 
the skin from sunken vitality. 

In all of the varieties of scarlet fever, you must rub the 
body with old bacon often enough to quiet irritation and itch- 
ing of the skin. Some recommend other inunctions, but I 
have found nothing to equal old bacon. 

Local Application. — If the patient can gargle, then you 
can mix from five to ten grains of permaiigauate of potash to a 
goblet of water and let him gargle ever}' six to eight hours. 
It is soothing, healing, and a disinfectant to the foul odor com- 
ing from the mouth and throat. In children, or those who 
cannot gargle, you may use the mixture with an atomizer. If 
in addition to the exudation, the tonsils should be so enlarged 



THEORY AND PRACTICE OF MEDICINE. 193 

as to impede the breathing, then you can use the peroxyd of 
hydrogen with an atomizer every hour till the tonsils are re- 
duced so that there is no danger of suffocation ; or, if this 
proves insufficient, and there is great danger of suffocation 
from the enlarged tonsils then you can introduce a rubber tube 
between the tonsils, and let it hang out on the side of the 
mouth. In this way the patient can breathe through the 
tubing. For the swollen neck I invariably have the nurse cut 
old fat bacon in thin slices, and sprinkle a little fine salt and 
pepper on them and bind them on the external neck. When 
they cause fine pimples to appear they may be taken off, and 
a dry cloth supply their place. 

Sequelae. — The most dangerous complications following 
scarlet fever are inflammation of the ears, and glands about the 
neck, nose, eyes, kidneys, and dropsy. 

Otitis and Otorrhcea. — Otitis or inflammation of the in- 
ternal ear is a very painful and annoying affection whether the 
result of scarlet fever or from cold. The ears feel sore and 
swollen at the beginning, and soon the pain becomes almost 
unbearable, and unless the inflammation is speedily arrested 
an abscess of the middle ear will be the result, with perfora- 
tion of the tympanum. The danger of this affection is, that 
it may extend to the dura mater, and prove fatal, by inflam- 
mation of the brain. Or the perforation of the tympanum may 
be followed by an otorrhcea and permanent deafness. I am glad 
to tell you that the majority of the cases may be prevented or 
cured by homoeopathic treatment. 

Treatment OF Otitis. — As soon as pain is felt in the 
ear you mix two drops of a dilution of aconite in a teaspoon- 
ful of warm water and fill the ear; the water must be as 
warm as the patient can bear it. As soon as the mixture gets 
cold in the ear then it may be allowed to run out. If the 
pain is not relieved, you must repeat the application until the 
patient is relieved. It should be repeated every one to two 
hours, or as often as the pain returns. By this plan of treat- 
ment you will save a majority of cases from running into an 



194 THEORY AND PRACTICE OF MEDICINE. 

abscess. At the same time that you are using- the medicated 
warm water you can give aconite internally every one to two 
hours. If aconite fails to give relief in a few hours, then you 
must resort to belladonna or Pulsatilla. If the ear has a 
bright red color, face and eyes red, with headache, then bella- 
donna is your remedy. On the other hand, if there are dart- 
ing, tearing pains, or stinging in the ear, and a feeling as 
though it was stopped up, then Pulsatilla is indicated. This 
remedy is the great ear remedy. 

I have frequently found that a drop of mullein oil put in 
the ear will give relief. For those terrible neuralgic pains 
chloroform often gives immediate relief. You take a small 
bit of absorbing cotton and put a few drops of chlo?'ofrom on 
it, then envelope the whole in a piece of dry cotton and intro- 
duce it into the ear and cover with a piece of paper to retain 
the fumes of chloroform. As a rule, you should never allow a 
patient to put cotton in the ear to exclude the atmosphere. 
It presses the ear and often makes it sore. No thick viscid 
oil should ever be used in the ear, for it causes an accumula- 
tion of dust to settle there. 

Otorrhcea or discharge from the ear. — When there 
is a discharge of bloody fetid pus, mercurius is called for. 
But if there is a discharge of pus from the ears, with hum- 
ming and tingling in the ears, and there is a hardness of hear- 
ing, as if the ears were stopped up, then Pulsatilla is the 
indicated remedy. 

Petroleum. — Petroleum is indicated where there is deaf- 
ness, with ringing, itching and cracking in the ears, and 
diminished secretion of wax. I have stopped the discharge 
and ringing in the ears by the use of petroleum and Pulsatilla, 
and restored many to hearing after many years standing. 

Glandular Swellings and Suppuration.— When the 
glands are swollen and hard, baryta carb. and rhus tox. are the 
first remedies to be given, these must be followed by protoio- 
dide of mercury. After suppuration takes place then you 
must give muriatic acid, arsenicum and sulphur, as they are 



THEORY AND PRACTICE OF MEDICINE. 1 95 

indicated. The patient must be nourished by milk, soft-boiled 
eggs and beef extracts. 

Nasal Catarrh. — This affection is often developed by 
scarlet fever. There is a thickening of the pituitary or 
Schneiderian membrane caused by congestion. The discharge 
is often thick, of a yellowish cast and bloody, or it may be of 
a greenish cast. If there is nothing blown from the nose the 
patient feels a dropping from the posterior nares which causes 
him to hawk frequently, especially in the mornings. 

Treatment of Nasal Catarrh and Ozena. — I now 
have reference to nasal catarrh following scarlet fever, and the 
chronic variety. Acute catarrh of the nose and bronchi comes 
under the head of colds, and hence I have no reference to the 
treatment of those affections at the present time. But the 
treatment I now give you has reference to the chronic variety, 
which if neglected merges into a fetid condition called ozena. 
Ulcers form in the nose and discharge a purulent matter, 
which sometimes becomes terribly offensive. 

Arum triphy Hum. —This remedy is indicated after diph- 
theria and scarlet fever, when there is a corrosive yellow dis- 
charge from the nose, which produces a raw chapped condi- 
tion of that organ. 

Aurum metallicum. — Produces an excessively fetid dis- 
charge, often looking like the white of an egg. The odor 
sometimes has a putrid smell when the nose is blown. Ca- 
ries of the nasal bones indicates this remedy. 

Hydrastis Canadensis. — Both internally and externally as 
a wash, is called for where ozena is present with a bloody, 
purulent discharge. 

Kali bichromicum. — Is called for when there is a tough 
ropy discharge from the nose, or dripping from the posterior 
nares. It is sometimes blown out in green masses ; or hard 
plugs. 

Mercurius biniodide. — This remedy is called for especially 
for nasal catarrh in scrofulous patients. The glands are swol- 



196 THEORY AND PRACTICE OF MEDICINE. 

len, the nasal bones become diseased, the nose discharges a 
whitish-yellow and often, bloody matter, mucus drops into the 
posterior nares, which causes a hawking, to get it out, es- 
pecially in the morning. 

Nitric acid. — Is indicated where there is a dirty bloody dis- 
charge from the posterior nares. Also for nasal ulcers with a 
yellow fetid discharge. 

Petroleum. — When there is a purulent discharge from the 
nose, and hawking of thick phlegm from the posterior nares, 
then you can try petroleum. 

Pulsatilla. — Green fetid discharges, or greenish hard masses, 
call for Pulsatilla. 

For a local application, a solution of permanganate of potash 
is an excellent remedy to disinfect or destroy the odor of nasal 
catarrh. It may be applied with atomizer or nasal douche. 

Iodine and carbolic acid are also good local agents, and may 
be used in the following way : Iodine, five grains ; carbolic 
acid, two grains ; chloi'oform, half an ounce ; mix and put into 
an ounce glass-stoppered bottle. Shake and inhale fumes 
morning and night. 

If the eyes are much swollen ; conjunctiva red, swollen, 
and a stinging pain, apis is called for. 

Arsenicum. — Is called for where there is thirst for water 
but patient can drink but a few sips at at a time. There 
is an intolerance of light, every thing appears green, eyes red 
and painful. 

Argentum nitricum. — This remedy is called for where the 
lids are swollen and red, conjunctiva red and painful, cornea 
ulcerated, profuse purulent discharge, with granulated lids. 

Belladonna. — Has intense redness and pain in the eye, 
with bright sparks before the eyes. Eyes dry, feeling of sand 
in the eyes, pupils dilated. Belladonna is one of the first 
remedies to be thought of in acute inflammation of the eyes. 

Euphrasia. — In catarrhal ophthalmia where there is much 
lachrymation and mucous discharge ; capillaries of conjunc- 



THEORY AND PRACTICE OF MEDICINE. 1 97 

tiva enlarged. Sensation as of sand in the eyes ; vesicles and 
ulcers of the cornea all call for euphrasia. 

Mercurius Corrosizms. — This is the remedy par excellence 
of the homoeopathic ophthalmologist. Some of my most bril- 
liant cures of ulceration of the cornea are attributable to this 
remedy. It is indicated where the pupils are contracted and 
insensible to light, deep ulcers on the cornea, with acrid dis- 
charges from the eyes, making the surrounding parts sore, 
with pimples or little boils around the eye. It is also indicated 
when the iris and retina are involved. 

Staphysagria. — This remedy is indicated where there are 
hot scalding tears flowing from the eyes when looking at a 
bright light. Also for hard crusts and little boils on the lids. 

Local Applications. — As a rule homoeopaths are opposed 
to the use of local applications. While it is true that a 
judicious selection of homoeopathic remedy internally is all 
that is necessary, yet sometimes local applications are very 
soothing, and often expedite the cure, therefore, I recommend 
the use of the following washes for diseases of the eyes follow- 
ing diphtheria and scarlet fever: Tincture calendula, ten 
drops ; hamamelis virginica, distilled, ten drops ; aqua dis- 
tillata, an ounce ; mix and drop a few drops into eyes morning 
and night. This is a soothing and healing application in 
highly inflamed eyes. If the lids are swollen, granulated and 
discharging a thick pus, the eyes looking like a piece of raw 
beef, then the following, in connection with the potentized drug 
internally, is an admirable treatment : Argentum nitricum, 
crystal, two grains ; aqua distillata, one ounce ; mix and drop 
into eye once a day, until discharge of pus is arrested. 

If the eye is painful, the cornea is ulcerated, and the iris 
and retina are involved, then we must resort to some means to 
prevent the exuded lymph from binding the iris and retina 
with adhesive bands, and thus obscure vision or produce total 
blindness. In order to prevent such an evil the iris must be 
kept expanding and contracting alternately until inflammation 
abates, and there is no possibility of adhesion taking place. 



198 THEORY AND PRACTICE OF MEDICINE. 

This object can be accomplished by sulphate of atropia, in the 
following way : Sulphate atropia, two grains ; aqua distillata, 
one ounce ; one drop into eye once a day until pain abates and 
the pupil is dilated, then discontinue the drops until pupil 
contracts again. In this way you relieve pain and overcome 
iritis and prevent adhesion. 

Post-Scarlatinal Dropsy. — Dropsy after scarlet fever 
is likely to follow any of the types, but more especially the 
simple variety. This is probably due to the fact that scarla- 
tina simplex is so mild that often there is but little medicine 
used, and hence the poison is not wholly removed from the 
system. This being true, then the kidneys having a double 
office to perform, and not having the appropriate remedies to 
assist them, the consequence is that a congestion, and suba- 
cute inflammation of the kidneys, is set up, and they are unable 
to perform their functions properly, and hence a post-scarlati- 
nal dropsy is the result. 

The symptoms preceding this trouble are a frequent desire 
to urinate ; the urine is scanty, highly colored, or of a smoky 
cast, owing to the presence of blood. It is of a high specific 
gravity, 1. 015 to 1.094. Normal specific gravity is from 1.015 
to 1.025. The pul se is quick, patient thirsty, and the skin is 
dry. The whole body soon becomes edematous. That is to 
say the areolar tissue is filled with a serous or watery fluid. 
The first indications of an improvement are a copious secre- 
tion of urine and abatement of fever. 

Treatment. — Apis is indicated when the skin is swol- 
len, and has a pale waxy appearance, soreness of the abdomi- 
nal walls ; stinging, burning pains in different parts of the 
body ; must sit straight up to get any ease ; urine scanty, dark, 
like coffee-grounds. 

Cantharis. — When there is pain in the loins, with scanty 
high-colored, bloody or albuminous urine, calls for cantharis. 

Apocynum Cannabinum. — This remedy has a sinking feel- 
ing at pit of the stomach ; bruised feeling in the abdomen ; 
irritable condition of the stomach ; obliged to sit up ; lying 



THEORY AND PRACTICE OF MEDICINE. 199 

down produces violent dyspnoea ; urine very scanty, thick, yel- 
low, and turbid. 

Arsenicum. — Is indicated when the skin looks livid, pale 
or greenish ; dropsical swellings of the abdomen and extremi- 
ties ; great debility and prostration ; faint feeling from slight 
motion. 

Helleborus. — Frequent desire to urinate, with scanty emis- 
sions ; after standing, the urine looks like coffee-grounds. 

Colchicum* — Face yellow and edematous, urine scanty and 
dark colored. 

Dropsy of the Scrotum or Hydrocele. — Iodine, rho- 
dodendron, Pulsatilla, sulphur, are the remedies indicated in 
this affection, and will usually cure if given in the acute stage. 
I have cured many cases without the use of the aspirator or 
trochar. Do not forget that a patient with scarlet fever should 
never leave his bed or his room until the skin is done peeling. 
Remember also to give instructions to have the urine exam- 
ined regularly, and the very moment it becomes scanty and 
highly colored, then is the time to ward off dropsy by appro- 
priate remedies. If the kidneys are acting freely, and the 
urine is normal ; that is, amber-colored, then you need not 
fear dropsy. 

DENGUE -FEVER. 

This is a fever of the continued type, occurring in the 
East Indies, the West Indies, and the southern states of Amer- 
ica. It is a disease which resembles rheumatism in some of 
its symptoms. Patients are awkward and stiff in their gait, 
and for this reason the natives of the islands call it dandy 
fever, and on account of the pains and stiffness it is also call- 
ed breakbone fever. Owing to the rheumatic symptoms and 
a peculiar rash, it is sometimes called eruptive rheumatic 
fever. It is supposed by Goodno that dengue is a Spanish 
corruption for "dandy." 



200 THEORY AND PRACTICE OF MEDICINE. 

Symptoms. — The disease is ushered in suddenly with 
vomiting, pains in the head, back and limbs, rigors are often 
present. The skin becomes hot and dry, pulse rapid, small 
and feeble ; face is red, eyes red and watery ; tongue red and 
clean. There is a remission of fever about the end of the 
third day, which lasts from two to four days, when nausea, 
heat, and muscular pains return, accompanied by an eruption 
which first appears in the palms of the hands. The rash 
sometimes resembles that of scarlet fever and measles. The 
disease lasts from ten to fourteen days, but the depression, 
both mental and physical, often last for sometime after conva- 
lescence has been established. 

Diagnosis. — The locality where it occurs, the aching 
of the bones, the red clean tongue, scarlet rash of the palms 
of the hands, is characteristic of dengue. 

Prognosis. — This is always favorable unless occurring 
in a broken down constitution, or it may prove fatal to infants 
by producing convulsions. 

Causes. — As this disease occurs in tropical climates we 
might infer that marsh miasmata had something to do with 
its origin, and yet there seems not to be malaria sufficient to 
produce bilious remittent fever. But whatever is its cause, 
whether a miasmatic ferment, or a micro-organism, frost de- 
stroys its virulency. 

Treatment. — In the febrile stage of this disease we 
must select the fever remedy in accordance with the symp- 
toms. It is my impression that gelsemium is more suitable 
for the fever in hot climates than aconite. The flushed face, 
red and watery eyes, dry red tongue, headache, etc., call for 
belladonna. 

Eupatorium is indicated for the pain and aching of the 
bones. 

Bryonia and rhus tox. are called for when joints are 
swollen and painful. 

Arsenicum and china for prostration following an attack 
of dengue. 



THEORY AND PRACTICE OF MEDICINE. 201 

ERYSIPELAS, or ST. ANTHONY'S FIRE. 

This is an idiopathic disease of the eruptive type. The 
peculiar redness of the skin, which is characteristic of the 
disease, is called erysipelatous inflammation. It is called 
erysipelas because of its tendency to spread. It is sometimes 
called Saint Anthony's fire, because St. Anthony was supposed 
to cure it miraculously. The disease often starts from a given 
point upon the body, and travels each way. It was once 
thought that when the belts of inflammation met the patient 
would die. This, however, is a mistake ; for I have frequently 
seen the inflammation spread each way until they met, and 
spread down the body and pass off at the great toe, and the 
patient recovered. 

Erysipelas may be divided into two primary classes — idio- 
pathic and traumatic. In the former the disease is developed 
within the system by zymosis, and manifests itself by general 
and local phenomena. Traumatic erysipelas is induced by 
dissection wounds, or by bringing the erysipelatous virus in 
contact with wounds after amputations, or other surgical op- 
erations. If a patient is placed in a hospital or room, after an 
operation, where there is a case of erysipelas, the wound will 
soon give evidences of the presence of inflammatory action of 
an erysipelatous character. Thus the virus having found 
access to the system through a wound, and having established 
a nucleus in that part, it there concentrates its forces. If the 
patient be in the plastic diathesis the virus is immediately sur- 
rounded by a wall of plastic lymph and made to localize itself 
on the part ; and it only produces a temporary trouble. But 
if the patient be aplastic the virus readily enters the system 
and the patient succumbs to the ravages of the disease. 

The different varieties of erysipelas, under the term spo- 
radic, all proceed from one and the same general cause ; but 
differ in their local manifestations. 

I will first give a classification of the different varieties of 



202 



THEORY AND PRACTICE OF MEDICINE. 



erysipelas, and then speak of it in its general character. The 
following table will exhibit erysipelas and its types. 



Erysipelas. 



Sporadic. 



{Erysipelas erraticum, 
Erysipelas ambulans, 
Erysipelas phlegmonodes, 
Erysipelas edematodes. 



Epidemic. . . . Erysipelas Maligna, or Black Tongue. 

Traumatic. ( £° ca J Erysipelas, 

^ Erysipelas gangrenosum. 



Erysipelas Erraticum is that form which begins at a cer- 
tain point on the body, and sometimes spreads to every part. 
Erysipelas ambulans, or walking erysipelas, may attack dif- 
ferent parts of the body successively. Thus we may notice it 
on the face at one visit, and at our next it may be observed on 
the foot or leg. 

Erysipelas Phlegmonodes is that form which pene- 
trates deeply into the tissues. It is a very painful variety, and 
is often accompanied by suppuration and gangrene. 

Erysipelas Edematodes is that form of erysipelas which 
occurs in anaemic patients. The inflamed parts become edem- 
atous, and the color is not so red as in the other varieties. 

Symptoms of Sporadic Erysipelas. — Erysipelas, 
like the other idiopathic diseases, is ushered in by general 
uneasiness ; chilly sensations, headache, soreness of the throat, 
and stiffness of the neck. If the tendons and muscles on each 
side of the neck are stiff, it is diagnostic of erysipelas. The 
pulse is quick, and imparts to the finger a vibratory or wiry 
feel. This peculiar character of the pulse, if once understood, 
may always lead us to suspect erysipelas even before the erup- 
tion makes its appearance. The eruption is from one to three 
days in making its appearance. It may appear on any portion 



THEORY AND PRACTICE OF MEDICINE. 203 

of the body, but the face and sides of the nose are its most 
favorable sites It begins as a bright red spot, which gradually 
extends in every direction, There are, generally, small blis- 
ters on the inflamed skin. The parts are red, shining and 
tense. The face and scalp become swollen, and sometimes 
enormously distended. I have frequently seen abscesses form 
over the eyes and scalp. The inflammation often extends over 
the whole body unless speedily arrested ; or, as before stated, 
may skip from part to part. 

As the eruption extends the parts first attacked generally 
dry up and the skin peels off. This stage of drying and des- 
quamation begin about the fifth day, and end about the tenth. 
If the eruption is confined to the cutaneous surface, it may pass 
rapidly over the parts, and produce an itching and burning 
sensation, without producing much change in the parts, except 
a little exfoliation of the cuticle. But if the subcutaneous 
tissues are involved, the pain is often intense, and an effusion 
is thrown out in the parts, and an abscess is often the result. 

The grade of febrile action is in proportion to the plas- 
ticity of the patient. If the patient is in the plastic diathesis 
the fever is sthenic, and the parts seldom suppurate. But if 
he is in the aplastic diathesis the fever is asthenic, and the 
parts readily suppurate, and we often have a low typhoid con- 
dition of system. The pulse is feeble, the tongue is dry and 
brown, the stools are thin and watery, the eruption is of a livid 
color, and gangrene is often present. Death may take place 
from general prostration, or from metastasis of the external 
inflammation to some of the internal organs. Death, however, 
seldom takes place in sporadic erysipelas, unless the system 
has already been prostrated before the attack. But a more 
dangerous form of the disease often prevails epidemically. 
This has been called malignant erysipelas or black tongue. 

Erysipelas Maligna. — This disease has proved to be a 
terrible scourge in some parts of the world. The first and 
only case I ever saw was treated by my preceptor. The pa- 



204 THEORY AXD PRACTICE OF MEDICINE. 

tient first complained of stiffness of the jaws, and a burning 
pain on the side of the tongue. This was soon followed by- 
rigors and fever. The pulse became very frequent, ranging 
from 1 20 to 140 beats per minute, the tongue began to swell 
and turned black, and as the swelling continued, it protruded 
from the mouth ; the face was swollen, and abscesses formed 
in the cervical glands. This case occurred in the mountains 
of Virginia, and it did not assume that low grade of malig- 
nancy which has been observed in unhealthy localities of 
other portions of the world. 

During the epidemic of 1842 and 1843 tne disease was 
very fatal. In some cases the malignancy was observed from 
the beginning of the attack. In others the case assumed a 
somewhat sthenic character at the beginning, but soon merged 
into a low typhoid condition from which very many patients 
never rallied. 

Causes. — The causes of erysipelas are predisposing and 
exciting. The predisposing cause is the aplastic diathesis. 
The exciting causes are both local and epidemic. The causes 
are not well understood. It is a well known fact, that if a 
patient with a suppurating wound be permitted to remain in 
a crowded and badly ventilated hospital, all, or nearly all, of 
the inmates will be affected with erysipelas. It is evident 
then that a morbific agent, or bacillus, is liberated by the 
chemical change that takes place in the animal fluids ; and all 
persons who are brought under its influence long enough to 
change their diathesis will be the subjects of erysipelas. 

The same influence may be generated in private dwellings, 
where man}' persons are permitted to sleep in badly ventilated 
rooms. The agent, whatever it is, is governed in its action 
by local and atmospheric influences. Whether the erysipela- 
tous virus is conveyed from place to place through the atmos- 
phere, or whether it is generated in certain districts, and is 
governed in its manifestations by electrical changes of the 
atmosphere, the profession has not yet decided. 

I believe that the germ is of local origin, and it is excited 



THEORY AND PRACTICE OF MEDICINE. 205 

into action by atmospheric changes, and that the character 
of the disease will be grave or otherwise in proportion to the 
diathesis of the patient and the epidemic influence of the 
atmosphere. That is to say, if the local causes are sufficient 
to generate the erysipelatous virus, and if the community is 
in the plastic, or normal condition, then we may have spo- 
radic cases of erysipelas occurring immediately in the locality 
where the morbific agent is developed. But if the atmos- 
phere is such as to render the inhabitants aplastic, then the 
disease spreads from house to house by what is called an epi- 
demic influence. 

Diagnosis. — The diagnosis of erysipelas is not difficult 
The quick wiry pulse, and stiffness of the sides of the neck 
are diagnostic symptoms before the eruption appears. The 
peculiar color of the rash, and its tendency to spread, leaves 
no doubt as to the character of the disease. When it occurs 
in the fauces it is sometimes difficult to distinguish it from 
other affections of the throat. But, as before remarked, the 
vibratory sensation communicated to the finger by the pulse, 
and the tendency of the inflammation to spread to the sur- 
rounding structures, will enable us to diagnose the character 
of the trouble. 

Prognosis. — The prognosis of this disease is generally 
favorable in sporadic cases. In some epidemics, as before re- 
marked, the disease is very fatal. But even in the worst 
forms of the disease many patients may be saved by early and 
judicious treatment. 

Some authors tell us that erysipelas has been productive 
of much good, by removing obstinate cutaneous diseases. It 
has been asserted that elephantiasis, impetigo, psoriasis, and 
syphilitic affections, have been cured by an attack of erysipelas. 

Treatment. — The treatment of this disease must be 
both general and local. The general treatment must be di- 
rected to the arrest of zymosis and inflammation, and to the 
promotion of the plastic, or normal diathesis. For, as I have 
before had occasion to remark, erysipelas seldom or never, at- 



2o6 THEORY AND PRACTICE OF MEDICINE. 

tacks the normal diathesis except by inoculation. Therefore, 
if the patient is aplastic, the sooner we change his diathesis, 
and bring him into the plastic state, the sooner will we be 
able to arrest the disease. 

There are three things to be taken into consideration in the 
treatment of erysipelas. That is to say, we have the erysipe- 
latous virus, the aplastic diathesis, and zymosis to combat. 
The first two are essential elements in the development of the 
disease, and the latter is the means by which the leaven is 
diffused through the system ; and the spreading of the cuta- 
neous inflammation marks the degree of activity of the fermen- 
tative process in the aplastic system. Fortunately for the con- 
venience of homoeopathic physicians the unchangeable law of 
cure — " Similia similibus curantur" — that is a like cures 
like " — points out the remedy for each stage and condition of 
the disease. That is to say, the physiological action of medi- 
cines on healthy subjects point out the therapeutic indications 
for the treatment of erysipelas, and all other diseases. 

For the beginning of the febrile stage before the eruption 
appears, aconite and veratrum viride will be your best reme- 
dies. If there is a full bounding pulse, redness, burning and 
tingling of the face, the patient cannot bear the pain, and dis- 
likes to be touched or uncovered, then aconite is indicated. 
But if there is a high fever, with uausea and headache, then 
veratrum viride is indicated. After the rash appears, you 
must select your remedy in accordance with the character of 
the eruption. 

Non-Vesicular or Smooth Variety. — If there is much 
puffy swelling with a stinging sensation, then apis must be 
given. 

Belladonna. — Is indicated when the skin is bright red and 
shining. The redness begins in a small spot, and runs in 
streaks from the center; headache is often intense, there is 
throbbing of the carotids. Belladonna is more especially indi- 
cated for facial erysipelas. 



THEORY AND PRACTICE OF MEDICINE. 2QJ 

Bryonia. — If the joints are affected, hot, swollen, with 
inability to move them ; patients want to remain perfectly 
quiet, turns nauseated and faint when moving ; lips parched 
dry, and cracked ; headache as if it would split open. 

Pulsatilla. — This remedy is useful both for erysipelas errati- 
cum and ambulans. It is indicated when the skin has a hard, 
bluish-red swollen appearance, with burning heat and sting- 
ing pain ; vertigo when rising from a sitting posture, with 
chilliness. 

Vesicular-Variety. — Cantharis has vesicles, with much 
irritation, burning and serous exudation. 

Croton tiglium. — Scarlet redness of the skin, with rash-like 
vesicles ; itching, followed by painful burning. 

Rhus tox. — This is indicated for vesicular erysipelas in any 
part of the body ; intolerable burning, itching, and tingling in 
the affected parts. 

Veratrum viride. — This remedy is called for in vesicular 
erysipelas with gastric and cerebral complications. 

Phlegmonous Erysipelas. — This you will remember is 
an inflammation in the cellular tissue with a tendency to 
suppuration. 

Carbo veg. — Causes stagnation in the capillaries, causing 
blueness, coldness; ecchymosis. 

Graphites. — Head and face swollen, with burning, tingling 
pains; vesicular eruptions, discharging a sticky glutinous 
fluid. 

Hepar sulphur. — Is indicated where there is a tendency to 
suppuration, with an empty feeling at the stomach. 

Treatment of Edematous Erysipelas. — Apis is in- 
dicated where there is much swelling, with a pale reddish hue 
of the skin, with a stinging pain ; chilliness from the least 
motion ; dryness of the throat, without thirst ; urine dark and 
scanty. 



208 THEORY AND PRACTICE OF MEDICINE. 

Treatment of Malignant Erysipelas. — Arsenicum 
is indicated when the parts assume a blackish hue, with a ten- 
dency to gangrene ; burning pains, the parts burn like fire ; 
rapid prostration ; great anguish, extreme restlessness, and fear 
of death ; intense thirst, drinking little and often ; gangrene of 
the tongue ; spots on tongue burn like fire. 

Crotalis. — Tongue livid ; thick. 

Lachesis. — Is indicated when there is a tendency to gan- 
grene ; ulcers sensitive to touch ; ichorous offensive discharge ; 
cellulitis, with burning and blue color of the skin ; tongue 
dry, black and stiff. 

Opium. — Is indicated in any form of erysipelas when there 
is a tendency to brain complication known by profound coma, 
with stertorous breathing ; face dark-red and bloated. 

Sulphur. — This remedy is called for when there is a ten- 
dency to become chronic, and when the vesicles are filled with 
pus. 

Local Applications. — Half a drachm tincture veratrum 
viride to a goblet of water, mix well and saturate cloths and 
apply to the inflamed parts ; renew as often as the cloths be- 
come dry. Cranberry poultice is also an excellent application. 

Traumatic Erysipelas. — This is a disease, which com- 
plicates injuries and operations. It is called local erysipelas, 
because it is developed in the stump after an amputation or a 
wound. It is called erysipelas gangrenosum, because gan- 
grene may follow local erysipelas. The primary symptoms 
are similar to those of erysipelas in general, only they are 
much more violent and grave. The parts become livid, 
sloughing, and discharge sanies and pus. The prognosis is 
unfavorable. 

Treatment. — The treatment must be prompt and ener- 
getic, if we hope to save our patient. 

Arnica. — This should always be given after a bruise, es- 
pecially if erysipelas and gangrene begin to appear. 

Arsenicum. — Parts swollen ; hot, shining burning red spots 



THEORY AND PRACTICE OF MEDICINE. 209 

and bluish blisters ; hard, red, painful swellings ; gangrene 
with fetid diarrhea ; great weakness and emaciation ; coldness 
and heat alternating. 

Crotalis. — Hot, bluish, moist gangrene ; fever and chills, 
of a severe type ; limb swollen and covered with black blis- 
ters ; emitting a foul, cadaverous smell ; grayish-white mass ; 
strength greatly reduced ; pulse quick and small ; skin hot 
and dry ; tongue livid, thick. 

Carbo veg. — Senile gangrene ; humid gangrene in cachec- 
tic persons with weak vitality ; foulness of the secretions ; 
great prostration. 

Lachesis. — Gangrenous blisters, look bluish or black ; ves- 
icles increasing in size, with violent, cracked skin and deep 
rhagades ; coldness of the part ; painful spots appear on rub- 
bing, with dark blue borders ; traumatic gangrene. 

Secale comutum. — Dry gangrene of the extremities ; parts 
are dry, hard, cold and insensible, black and free from fetor ; 
large ecchymosis, blood blisters becoming gangrenous ; limbs 
cold, pale and shriveled, with insensibility. 

Local Treatment. — I am aware that a poultice is con- 
sidered rather old-fashioned by many surgeons of the present 
time ; but, nevertheless, I know that I have often had good re- 
sults from a bread and milk poultice containing carbo veg. I 
usually put a large spoonful of powdered carbo veg., to a half 
pint of the bread and milk. The poultice must be changed 
as often as it gets dry. I have seen it cause the sloughing to 
separate from the line of demarcation and leave healthy gran- 
ulations. 

If there is a discharge of offensive sanies, I have the parts 
washed once a day with tepid water, containing a drachm of 
carbolic acid to a quart of water. It is best to use a fountain 
syringe with as much pressure as the patient can stand, so as 
to loosen up the tissues and let the antiseptic penetrate deeply. 

The peroxyd of 'hydrogen is highly beneficial if used with 
an atomizer or syringe. The case must be watched carefully, 
and if any unfavorable symptoms develop before the line of 

14 



2IO THEORY AND PRACTICE OF MEDICINE. 

demarcation is established, then an operation should be re^ 
sorted to at once. The patient being in the lowest grade of 
the aplastic diathesis, he should be nourished with milk and 
beef extract. 

PLAQUE— PESTILENTIA. 

This is a fever of the continued type, and in some re- 
spects resembles typhus fever. , It is endemic in Egypt. It 
was carried to England in 1665, where it proved a terrible 
scourge. It is known in some places as the black death, the 
pestilence, and the levant plague. 

Causes. — It is a specific malarial poison arising from 
filth, carrion, and offal. 

Prognosis. — Very fatal in some epidemics, depopula- 
ting whole villages. 

Symptoms. — We know nothing about this disease in 
America except what we get from foreign writers. I quote 
from Ruddock, an English author. After a period of incuba- 
tion, lasting from a few days to three weeks, the disease breaks 
out with such virulence as sometimes to carry off its victim 
within a few hours ; the patient suffers from restlessness, 
rapid exhaustion, mental anxiety, shivering, headache, vertigo, 
nausea, vomiting, swelling of the tongue, labored breathing, 
pains in the glands of the neck, arm-pits, and groins, in which 
appear the characteristic buboes, carbuncles, petechise, con- 
stipation, and sometimes suppression of urine. Delirium or 
coma supervene in fatal cases. In favorable cases a profuse 
sweat occurs about the fifth day, and the buboes suppurate, or 
more generally disperse. 

Treatment. — This must be upon general principles, as 
laid down for typhus fever. The remedy must be selected to 
cover each stage or symptom as they arise. 



THEORY AND PRACTICE OF MEDICINE. 211 

TUBERCULOSIS, or SCROFULOSIS. 

These terms are synonymous, and they refer to that pecu- 
liar diathesis, or condition of system in which there is a ten- 
dency to the deposition of tubercles, or tuberculous matter, in 
some of the organs or tissues of the body. 

The tuberculous deposit consists, first, of a small hard gray 
substance called the miliary tubercle — named from its resem- 
blance in size to that of a millet seed ; second, and of a soft 
grayish, or yellowish matter, which seems to infiltrate the 
tissues. When tuberculous matter is deposited in the lungs 
that pathological change is called phthisis or consumption. 
If it is deposited in the mesenteric glands it is called tabes 
mesenterica, and when deposited in the bones, lymphatic 
glands, and tissues it is called scrofula. Tuberculosis of the 
bones, and external organs generally, occurs in early life, if it 
is hereditary ; but if it is acquired it may occur at any period 
of life. That form called phthisis is developed between the 
ages of sixteen and thirty, when the diathesis is hereditary ; 
but it may be acquired and destroy the patient at any period 
of life. 

Causes. — The causes of tuberculosis are both primary 
and secondary ; the former embraces the hereditary taint, 
whilst the latter includes all of those causes which directly 
call into action the hereditary tendency, and which so acts 
upon the system as to induce the tuberculous diathesis. 
Climate has much to do in calling into action the hereditary 
diathesis. We have, in our own country, three climatic regions 
in which tuberculosis is more readily developed in one than in 
the other. North America has been divided into three climatic 
regions, by imaginary lines drawn from Philadelphia to San 
Francisco. The other from the mouth of the Savannah river 
in Georgia to the Pacific Ocean. That portion of country 
north of the first line, is called the northern division ; that 
between the two lines, the middle division, and that on the 
south of the second line, the southern or gulf division. In the 



212 THEORY AND PRACTICE OF MEDICINE. 

first division winter or cold predominates with an average tem- 
perature of 40 to 45 F. In the middle division summer pre- 
dominates with a mean temperature of 60 ° F. The gulf divi- 
sion has but little or no winter, with a temperature of 65 ° to 
75 . We learn from the statistics of the standing armies in 
each division, that the rate of mortality from consumption, in 
that part of the northern division, north of New York, was 
forty-three out of every one thousand deaths ; south of New 
York to the Gulf, it was sixty-three in one thousand ; around 
the western lakes, nineteen in one thousand ; north of St. 
Louis, thirty-five in one thousand ; south of St. Louis, sixty- 
three in one thousand ; around the Gulf, sixty-eight in one 
thousand. These figures show that warm, damp climates, are 
more favorable to the development of tuberculosis than dry, 
and cold ones. Near the lakes of the north-western states has 
been considered the best climate in North America, for the 
residence of consumptive patients ; probably the table lands 
of Texas, New Mexico, parts of California and Florida are 
excepted. 

A want of exercise, nutritious diet, and an insufficient 
amount of clothing, are sufficient to call into action the tuber- 
cular diathesis. The intemperate use of ardent spirits, coupled 
with exposure and hardships, are prolific causes of tubercu- 
losis. The more wealthy classes, who exclude fresh air from 
their sleeping apartments, and take but little exercise, and are 
irregular in their diet and habits, are prone to this disease. 



PHTHISIS PULHONALIS or CONSUflPTION. 

This is a constitutional disease, which is characterized by 
a deposition of tubercles, or of tuberculous matter within 
some portion of the lungs. The terms phthisis and con- 
sumption indicate a wasting of the tissues. Therefore, when 
tuberculous matter is deposited in the lungs, the final result 
is a wasting or consumption of the lungs and tissues of the 



THEORY AND PRACTICE OF MEDICINE. 213 

body. There are three stages of development of phthisis : 
First, the tuberculous diathesis, or forming stage of the tuber- 
cles ; second, the deposit, and third, that in which the tuber- 
cles are fully developed and suppurate. Each of these stages 
has a clinical history and symptoms peculiar to itself. 

The hereditary tuberculous diathesis, is characterized by 
fine silky hair, long eyelashes, soft muscles with increased 
nervous susceptibility, anaemia, and an abnormal size of the 
joints of the fingers. If proper hygienic agencies are employ- 
ed in this stage, the disease can be arrested. But if left alone, 
the second stage supervenes with a slight hacking dry cough, 
on rising in the morning, and after eating. The cough is so 
slight as often to pass unobserved b} 7, patient or friends. If 
the pulse be examined at this stage, it will almost always be 
120 per minute. The respiration is quickened, the face is 
pale, the patient begins to lose flesh, and takes cold very ea- 
sily. He now begins to raise mucus with little granules, fre- 
quently streaked with blood. He becomes short of breath, 
frequently throws off pure blood, or may have frequent hem- 
orrhages from the lungs, and complains of soreness of the 
chest. The chest becomes tender by pressure over the site of 
deposit. The patient has some fever during the evening, the 
cheeks are a little flushed, and he breaks out into a copious 
perspiration during the night. The hectic fever and the 
night-sweats mark the rapid progress of the disease. The 
patient feels languid and looks pale on rising in the morning.. 
These symptoms continue for a longer or shorter period, when 
the third and last stage supervenes. The patient now begins, 
to cough hard and frequently. The expectoration becomes 
more copious, and consists of muco-purulent matter; thus 
giving evidence of the suppurative stage. The patient now 
becomes more rapidly emaciated, the sleep is disturbed by the 
cough, and the night-sweats become more profuse, and ex- 
haustive to the patient. One or both cheeks are suffused 
with a circular patch of a crimson hue. The patient now 
lives between hope and fear. One day he is animated, and 



214 THEORY AND PRACTICE OF MEDICINE. 

has hopes of recovery ; on the next he is despondent and 
gloomy. The digestive organs are variable ; sometimes they 
are normal, at other times they are deranged, and the patient 
is often troubled with an exhaustive diarrhea. As the disease 
advances the patient becomes a mere skeleton ; the feet and 
legs begin to swell; he becomes restless, and desires to change 
from place to place ; the cough becomes deep, hollow, and 
rattling ; the mind begins to wander, and death steps in and 
closes the scene. 

There are other symptoms, or evidences, of the presence 
of phthisis, than those already mentioned ; these are called 
physical signs, and are made manifest by auscultation and 
percussion. 

Physical Signs. — In the first stage of phthisis, there 
is an alteration in the natural respiratory murmur, and an in- 
creased density of the lung. In the second stage, we hear a 
prolonged, rough, irregular respiratory sound, and finally have 
dullness on percussion. In the third stage we have mucous 
rhoncus and pectoriloquy. 

These signs are generally manifest over the clavicular 
spaces, and more generally on the left side. This is the rule, 
but there are exceptions, for miliary phthisis is more liable to 
affect the lower lobe of the left lung. 

Anatomical Characters. — The tuberculous matter is 

generally deposited in the apex of the lungs, and is more 
frequently found in the left. Miliary tubercles may be found 
scattered throughout both lungs. I once examined the lungs 
of a cadaver in which the middle lobes were almost filled 
with tubercles, varying in size from a pin's point to that of a 
pea. Softening had not taken place, the patient had died 
from some acute disease. The upper portion of the lungs 
were in a normal condition. I have also examined lungs in 
which the tubercles were beginning to soften, and in which 
cavities had already formed. Tubercles are composed prin- 
cipally of decaying organic materials, without, however, vi- 
tality enough to organize. Cells, in the act of formation, not 



THEORY AND PRACTICE OF MEDICINE. 215 

being supplied with healthy blood, lose their vitality, and be- 
gin to decay, and in their half-formed state they are carried 
along by the circulation, and deposited in the first gland, or 
tissue that happens to be morbid, and resists its passage. 
Consequently, the development of tuberculosis, is by deposit ; 
and after the deposit has taken place, it begins to soften and 
suppurate, when the tubercles have lost all vitality. It is 
supposed by most writers, that softening begins at the center 
of the mass. 

The tubercles undergo various changes in color during 
the stages of deposit and softening, owing, probably, to some 
degree of inflammation of the surrounding tissues, or to the 
remaining vitality of some of the decaying cells. When soft- 
ening once begins, it continues until the whole mass of tu- 
bercles is expectorated, or reabsorbed. Inorganic materials 
are often found in the lung tissue, after the tuberculous mat- 
ter has been reabsorbed; thus the fact is demonstrated that 
the tubercles are not wholly of organic origin. If the de- 
posit is not extensive, and only occupies one lung, the patient 
is apt to recover. We have many evidences of this fact. I 
once examined the lung of a person who died suddenly of an 
acute disease. The family physician informed us that twenty 
years previously, he had treated the lady for phthisis, and that 
she had a cavity in the middle lobe of the left lung, but had 
recovered, and enjoyed good health. The lungs were in a 
healthy condition, except in the middle lobe of the left lung, 
there was a cavity large enough to contain a hen's egg. The 
cavity was cicatrized, and the tissues looked normal. Thus 
was demonstrated the doctor's diagnosis, which he had made 
twenty years previously, and also the fact that patients do re- 
cover after the deposit, and softening of tubercles have taken 
place. 

Causes. — The causes of phthisis pulmonalis may be 
classified under two heads : viz., predisposing and exciting. 

Predisposing Causes. — The predisposing causes are either 
a hereditary taint, or those conditions which induce the tuber- 



2l6 THEORY AND PRACTICE OF MEDICINE. 

cular diathesis. A large majority of the cases of consumption 
are directly the result of a hereditary taint. While in a few 
the tubercular diathesis may be acquired by a sedentary life, a 
low and unwholesome diet, impure air, reveling at night, los- 
ing of sleep, the abuse of intoxicating liquors, and every thing 
that depresses the vital powers, and retards assimilation. It 
it supposed that the use of cistern and well waters, which do 
not contain iodine and bromine, are predisposing causes of 
tuberculosis. While the use of spring water, which contains 
a mere trace of those agents, retards the development of phthisis 
and scrofula. 

Exciting Causes. — By a strict observance of the laws of 
health, a patient with the tuberculous diathesis may pass to a 
good old age without phthisis being developed. But if those 
laws be disregarded, or the normal condition of the lungs be 
perverted, then the tubercular diathesis may be excited to 
action. All agencies which call into action this diathesis, are 
called exciting causes. Cold, vicissitudes of climate, and every 
thing that produces irritation of the lungs, or retards the cir- 
culation through them, are exciting causes of phthisis, and 
hasten the deposition of tubercles. Hence it is that we often 
see phthisis developed after an attack of pneumonia and bron- 
chitis. Now it is evident that pneumonia and bronchitis never 
merge into consumption as some suppose. But they only call 
into action the diathesis which probably had lain dormant for 
years. All diseases of long standing, or those affections which 
produce a morbid condition of the circulation through the 
lungs, are liable to call into action the tubercular diathesis, 
and thereby become exciting causes of phthisis. 

Diagnosis. — The diagnosis of phthisis, as a rule, is not 
difficult, if we compare the physical signs with the clinical 
history, and general symptoms. The slight cough, frequent 
pulse, anaemic condition of the skin, shortness of breath, 
hemoptysis, and change of the natural respiratory murmur, 
all point to the first or incipient stag-e of phthisis pulmonalis. 

The increased cough, depression of the clavicular and in- 



THEORY AND PRACTICE OF MEDICINE. 217 

tercostal spaces, increased temperature of the body, loss of 
the respiratory murmur, and dullness on percussion, indicate 
the completion of the second stage. 

The continued prostration of the patient, rapid emaciation, 
profuse night-sweats, hectic fever, swelling of the feet, mucous 
rhoncus, expectoration of muco-purulent matter, and pectoril- 
oquy, are diagnostic symptoms and signs of the third and 
last stage of consumption. 

I regard the frequent pulse, as almost an infallible diag- 
nostic sign of phthisis pulmonalis, in the absence of any 
general febrile excitement to account for its frequency. When 
tubercles are being deposited in the lungs, the pulse is hardly 
ever less than 120 per minute. It is believed that if a depo- 
sition of tuberculous matter be going on in the lungs, the 
thermometer will show a gradual increase of the temperature 
of the body, without, however, its being perceivable to the 
sense of touch. 

Hemoptysis is justly regarded as the forerunner of con- 
sumption, and when it is not the result of acute bronchitis, or 
cardiac affections, it becomes an alarming symptom. The 
history of the case will show whether the depressions of the 
clavicular and intercostal spaces are due to previous inflam- 
mations and adhesions, or to tubercular deposit. And the 
general symptoms will remove all doubt as to whether the 
dullness on percussion is due to pneumonia, or to the deposi- 
tion of tuberculous matter. And, lastly, the muco-purulent 
expectoration, and pectoriloquy, will give unmistakable evi- 
dence of suppuration, and the formation of a cavity. The 
microscope reveals the bacteria in the pus globules. 

Prognosis. — The prognosis of phthisis is generally un- 
favorable. A few cases of the hereditarv diathesis ma}- be 
warded off, and the patients live to be a good old age ; but 
the rule is that they may die sooner or later with consumption. 
If the diathesis is acquired, very many recoveries do take 
place even after the formation of an abscess. The case that 
I have already related, in which the lady enjoyed good health 



2l8 THEORY AND PRACTICE OF MEDICINE. 

for twenty years after an attack of phthisis, is proof positive 
that patients do often recover after the third stage has super- 
vened. But, your prognosis must be guarded, for I must re- 
mind you that death is the rule, and recoveries the exception, 
in the third stage of consumption. But it matters not how 
unfavorable the case may seem to be, it will be your duty to 
encourage your patients 'and give them all the benefits of a 
reasonable hope of recovery. 

Treatment. — If it be true that the tuberculous deposit 
is principally composed of partially developed cells, or decom- 
posing protein compounds, then it is evident that the treat- 
ment must be addressed to the removal of the diathesis. If it 
be true that the albuminoid substances have a tendency to 
decay and to suppurate, then may we not infer that the treat- 
ment which has been found most beneficial in overcoming the 
aplasticity of the system, will be the one best adapted to the 
removal of the tuberculous diathesis ? Clinical experience has 
demonstrated this to be true ; for, as yet, every agent, which 
has been of any benefit in arresting the further invasion of 
phthisis, belongs to that class of remedies which are capable 
of increasing the plastic condition of the system. 

The treatment of phthisis naturally divides itself under 
three heads : 

i. The removal of the diathesis. 

2. The arrest and elimination of the deposit. 

3. To alleviate the patient's suffering, prolong life, and 
smooth his pathway to the grave. 

I remark that ninety-nine cases out of every hundred may 
be cured in the first stage by proper hygienic regulations and the 
use of remedial agents, and a change of climate. The first and 
most important indications are exercise, fresh air, and a nutri- 
tious diet. The patient should spend the most of his time in 
the open air. Exercise should be taken by walking, playing 
ball, rolling hoop, or by horse-back riding. A patient can re- 
ceive but little or no advantage by being shut up in a close 
easy-going carriage. He had better, by far, ride in an open 



THEORY AND PRACTICE OF MEDICINE. 219 

lumber wagon. The lungs should be fully expanded several 
times a day by fresh air, and the patient should take such 
exercise as to bring all of the muscles of the body into action. 
By this means the circulation is accelerated, respiration is 
quickened ; thus more oxygen is diffused through the tissues 
of the lungs and purifies the blood, and thereby promotes the 
reabsorption and elimination of decaying cells that may be 
entangled in the tissues. Exercise in the open air should be 
strictly enjoined, especially in children of a scrofulous diathe- 
sis, for without this all else will fail. Clothe in flannel, keep 
the feet dry, and let them run out of doors both winter and 
summer. The sleeping-room should be thoroughly ventilated 
night and day. There is probably nothing that so depresses 
the vital energies as bad ventilation. The diet should be 
nutritious and unstimulating. Alcoholic stimulants, in my 
judgment, should be strictly forbidden. Tea and coffee should 
be used in moderation. Milk should be used freely, or malted 
milk and milk should be combined, and not less than half a 
gallon of the liquid should be taken daily. They build up the 
patient's system better than any thing else. When the patient 
cannot take the malted milk, then he should drink half a gal- 
lon of water, or more, every twenty-four hours. Kggs, fresh 
meat, potatoes, rice, ripe fruit, especially grapes, may be eaten 
freely. In fact the stomach should be kept full of liquid 
aliments all the time, and once you get your patient to gain- 
ing flesh, if only half a pound a week, you may hold out hopes 
for a cure. 

It is said that Dr. A. Wilford Hall, a scientist, of New 
York City, cured himself of consumption forty years ago by 
the rectal douche, and he is now eighty years of age, and is 
hale and hearty. He has published a work on his plan of 
treatment called Health-Pamphlet. The subject is well worth 
your careful consideration. I have used his plan of treatment 
with much satisfaction. A sanitarium has been started in New 
York where his treatment has been adopted exclusive of medi- 
cines, and the reports are most favorable. 



220 THEORY AND PRACTICE OF MEDICINE. 

His treatment consists in flushing the colon with water as 
warm as can be borne. A fountain syringe is the best instru- 
ment to use. At first the patient may not be able to retain 
more than a pint or a quart, but after continuous use, half a 
gallon, and often a gallon, may be retained. He uses the 
enema once a day until the colon is thoroughly disinfected, 
then they may be given from one to three times a week. 
Patients seem to grain flesh and strength bv their use. There 
is nothing in this treatment to contraindicate the use of 
homoeopathic medication, but they march hand in hand to 
the promotion of health. Pure spring water, is said to con- 
tain traces of iodine and bromine, and on this account it is 
thought to be prophylactic to phthisis and scrofula, where it 
is used constantly, year after year. There seems to be some 
truth in this theory, when we compare the healthy and ruddy 
children of the mountains of Virginia and Vermont, with 
the pale and sickly ones of the Mississippi valley. In the 
former, we find bold and pure springs of water, while in the 
latter, many families are using waters from wells containing 
surface or cistern water. 

Medicines by inhalation have a tendency to allay irritation 
of the lungs, and to assist in softening the tubercles. Iodine 
and carbolic acid are the agents most generally used ; and 
probably the most convenient mode of using them is by 
combining them with chloroform in the following manner. 
Chloroform, half an ounce, iodine, five grains, carbolic acid, 
two drops, and put into an ounce vial with a glass stopper, so 
as to prevent the evaporation of the chloroform. The patient 
may be allowed to inhale the fumes two or three times a day 
in the following manner ; close one nostril and apply the vial 
to the other, and take a lone inhalation ; after waiting a few 
moments apply the vial to the other nostril in the same man- 
ner as before. The chloroform is only used to vaporize the 
iodine. 

If I were to mention all of the remedies that are indicated 
in consumption, I would exhaust the list of nearly all homceo- 



THEORY AND PRACTICE OF MEDICINE. 221 

pathic agents. I will therefore mention only a few of the 
most prominent, and refer yon to the materia medica for the 
rest. 

First Stage or Cachexia. — This is the stage in which 
yon must work faithfully in order to save your patient. I wish 
to repeat that without proper sanitary regulations, and a full 
nutritious diet, medicines will be of little avail. 

I mention calcarea carbonica, hepar sulphuris, calcarea, 
iodine, mercuriusbiniodide, and nux juglans, as the most suita- 
ble remedies in the first stage, or the tubercular diathesis. 

Calcarea carb. — This agent is indicated where there is 
imperfect digestion and assimilation, with relaxed bowels, and 
glandular swellings, and when the patient takes cold easily. 

Hepar sulphur. — Is indicated in the tubercular diathesis 
when the patient takes cold easily, and has a hoarse, rough, or 
weak voice, pain after eating the smallest quantity of food ; 
clay-colored, or greenish evacuations. 

Iodine. — You must remember that the long continued use 
of iodine in crude doses, produces a wasting of the tissues. 
Hence, if you find a patient who is losing flesh, and has a slight 
hacking cough, then iodine is your remedy. But you must not 
give it too low 

Mercurius biniodide. — This remedy is indicated for scrofu- 
lous glandular swellings, where there is a loss of flesh, while 
the glands may be enlarging. 

Nux juglans. — Is indicated for scrofulous cachexia, with 
swollen glands. 

Tuberculinum. — Dr. J. Compton Burnett, of I^ondon, rec- 
ommends the one hundredth and two hundredth dilutions of 
this agent for the first stage of consumption, and has reported 
many cases of cures. I have tried it in five cases of real con- 
sumption, but the patients died in spite of all remedies used. 
I have given it in several cases of the scrofulous diathesis with 
apparent benefit. The turberculinum is prepared by digesting 
tuberculous matter expectorated from the lungs in alcohol, 
the process is continued until the one or two hundredth dilu- 



222 THEORY AND PRACTICE OF MEDICINE. 

tions are reached. Some one asked Dr. Burnett if he did not 
think it was too nasty to give to a patient. He replied by 
saying that he did not think that the two hundredth dilution 
of any thing whatsoever — even of original sin — was not at 
least clean. 

A sponge bath, three or four times a week, of cold water 
containing sea-salt, is very invigorating, and helps to ward off 
the deposit by lessening the susceptibility of taking cold. 

Do not forget that your main dependence lies in building 
up the system by large quantities of liquid alimentation and 
fruits of all kinds. Patients ought to drink large quantities 
of water ; they may mix any of the fruit jellies with the water. 
When they crave any thing stimulating then allow them all 
of the unfermented grape juice they want, it is both nourish- 
ing and stimulating ; it is an organic stimulant. Malted milk 
is by far the best alimentation I have ever used to build up 
the system. 

Second Stage. — This being the stage of deposit we will 
have to change our treatment from the diathesis to the arrest 
and removal of the deposit. Owing to the congestion of that 
part of the lung, where the deposit is seeking to gain a hold, 
there are sometimes hemorrhages, or simply spitting of blood. 
This condition must be watched, for if neglected the patient 
may die from hemorrhage, called hemoptysis. 

Hamamelis virginica, ipecac, and phosphorus, are the 
first remedies to think of in hemoptysis. This is the stage 
in which some benefit may be derived from the iodine and car- 
bolic acid inhalation. Kreosote has a similar action to that of 
carbolic acid. The cough becomes very troublesome in this 
stage. 

Acid oxalic, belladonna, drosera, and hyoscyamus, are in- 
dicated when the cough is worse at night. If the cough is 
worse on lying down, then Pulsatilla, conium, drosera, hyos- 
cyamus, and laurocerasus, are your best remedies. 

Rumex and kali bichromictim, are indicated for a cough 
which is worse in the morning. 



THEORY AND PRACTICE OF MEDICINE. 223 

Manganum and sepia are indicated when the cough is re- 
lieved when lying down. 

In order to ascertain which of the remedies I have named 
is applicable to each individual case, you must take into con- 
sideration all of the symptoms, and then make your selection. 

Third, or Suppurative Stage. — Bryonia has a hard 
cough, with stitching pain in the side, especially the right. 

Antimonium tartaricum is indicated for profuse purulent 
secretion, with great distress, and dyspnoea. 

Stannnm is called for when there is a profuse expectora- 
tion of a yellowish-green color, and of a sweetish taste, and 
night-sweats. 

Phosphorus is a valuable remedy in tuberculosis in the 
tall, and slender patients, with hacking cough, and bloody ex- 
pectoration. 

Abscess in the lung calls for iodine, arseniciuh, china, 
silicia, hepar sulphur. 

Hectic-fever, night-sweats, and diarrhea, may be modified 
by the use of acid phosphor icum, china, hepar sulphur, sambu- 
cus, and stannum. A cup of cold sage tea is a valuable rem- 
edy for night-sweats. Muriate of cocaine 3X, is valuable to 
relieve night coughs. 

For diarrhea you have the whole range of the materia 
medica to cull from. I will only suggest that the color and 
consistency of the stool must be your guide for the selection 
of the indicated remedy. Nausea is overcome by ipecac, kre- 
osotum, apomorphia, etc. 

Bed=SOres. — The books give you a long list of washes 
and ointments to heal bed-sores. But in my experience they 
need not occur ; for if the patient is examined from day to 
day, and bathed properly, and have the projecting parts well 
padded, either with cotton, or rubber, then bed-sores will 
rarely occur. If, however, the parts become red, then if they 
are painted with the tincture of chloride of iron — called the 
muriated tincture — it will harden the cuticle, and prevent 
sores from forming. Or, if the skin is abraded, and ulcers 



224 THEORY AND PRACTICE OF MEDICINE. 

are forming, the application will arrest their progress and 
cause them to heal. If the parts are quite sore, then you 
must explain that the first application may smart, but after 
that, each application will grow less painful. If the patient 
is neglected until large angry sores are formed, then a calen- 
dula lotion can be applied three times a day. From ten to 
thirty drops of the tincture of calendula to a goblet of tepid 
water, makes an excellent wash. One ounce of castor oil 
containing ten to fifteen drops of carbolic acid, makes a splen- 
did disinfectant and healing lotion. 

SCROFULOSIS or SCROFULA. 

I need add but little more on scrofula than what has been 
said on phthisis. For the removal of the scrofulous struma, 
or diathesis, the same treatment recommended for the first 
stages of phthisis must be adopted for the removal of the 
scrofulous struma. Under the head of scrofulous struma, we 
have scrofula of the glands, hydrocephalus, tabes mesenterica, 
caries of the bones, white-swelling, and hip-joint disease. 

SCROFULA OF THE GLANDS. 

The scrofulous diathesis may induce enlargement of any of 
the glands of the body. Usually they are of slow growth, and 
often remain indurated a whole life-time without suppuration ; 
indeed that will never occur until, by external causes, the in- 
dividual is brought to the borders of the aplastic diathesis. 
When the system is in or near that condition, then cold may 
induce an inflammatory condition and produce an abscess of 
the glands. The discharge is rarely a thin pus ; but consists 
of a thick white cheesy substance. Long silky eyelashes, long 
slender fingers with large joints, are diagnostic symptoms of 
the scrofulous diathesis. 

Treatment. — For the removal of the scrofulous diathe- 
sis I refer you to my remarks on the treatment and hygiene of 



THEORY AND PRACTICE OF MEDICINE. 225 

the first stage of phthisis. For the removal of glandular scrof- 
ula you must keep your patient as near the plastic diathesis 
as possible by liquid alimentation consisting of milk, malted 
milk, beef essence, etc. Salt water sponge-baths three or four 
times a week, warm clothing, free ventilation of sleeping apart- 
ments. There is never any danger of a patient dying with 
scrofula, in any form, so long as you can keep him up to, or 
rising, his normal standard weight. Your greatest trouble will 
be to persuade the patient to follow your advice long enough 
to perform a cure. You had better tell him in the start that 
it will take you from twelve to twenty-four months to perform 
a permanent cure ; but if neglected it may prove fatal within 
that time. No scrofulous person should ever touch pork in 
any form. The Jews are the only sensible race on that subject. 
If you examine a hog's jole you will find hundreds of scrofu- 
lous nodules. Hence the Jews have always considered the 
hog unclean, and refuse to eat his flesh. 

If you can eradicate the strumous diathesis before the child 
reaches his fourteenth year, he will rarely ever be troubled with 
scrofula afterward. You should therefore urge upon parents 
the necessity of a proper attention to their nursery. Warm 
clothing, free out-door exercise, nutritious diet, and dry feet, 
are essential elements in the cure of scrofulous patients. 

Belladonna, hepar sulphur and aconite, are the indicated 
remedies for the inflammatory stage of glandular swellings. 
A cold compress is often beneficial, and if suppuration is about 
to take place, then a flaxseed or bread and milk poultice will 
give relief. While trying to prevent suppuration, you must 
give hepar sulphur high. But if you cannot arrest the forma- 
tion of pus, then while you are applying the poultice, if you 
give hepar snlphur in the ix or 2x trituration it will hasten 
suppuration. 

For chronic glandular enlargement, iodine, biniodide or the 
protoiodide of mercury are our most reliable remedies. If the 
glands are indurated, then ammonia muriate and rhus /^r.,are 
the remedies. Kali hydriodicum, Phytolacca, silicia and sul- 

15 



226 THEORY AND PRACTICE OF MEDICINE. 

phur are often called for. Do not forget that c ale are a carb. is 
one of our best agents in overcoming the scrofulous or tuber- 
cular diathesis. 

I think that from one to two years continuous residence in 
a warm climate with a sandy soil, such as Florida, with the 
treatment and hygiene to which I have already referred, will 
remove the scrofulous diathesis from ninety patients out of 
every one hundred. 

TABES MESENTERICA. 

CONSUMPTION OF THE BOWELS. 

This disease is characterized by tubercular deposits in the 
mesenteric glands. The abdomen becomes swollen and ten- 
der, and the bowels are relaxed. The patient has a pale, sickly 
look, characteristic of the scrofulous diathesis. 

Treatment. — Iodine, arsenicum, arsenicnm iodide and 
calcarea carb., are the principal remedies in this disease. Cal- 
carea carb., is especially indicated for enlarged hard abdomen 
and a want of assimilation. 

The hygiene, diet, clothing and exercise must be the same 
as recommended for phthisis. 

CARIES. 

This is the result of an inflammation of a bone, which often 
ends in its death and sloughing. It mostly occurs in the 
scrofulous diathesis. It may occur in any of the bones of 
the body, but it more generally takes place in the vertebrae, 
hip-joint, and knee. When it occurs in the spine, it produces 
an angular curvature, by decay of the bodies of the vertebrae, 
which causes the vertebrae above and below the diseased ones 
to fall together, thus making a hump or projection in the 
back. When the disease occurs in the knee, it is called white- 
swelling, from the white appearance of the swollen knee. 
As the progress of the disease, and treatment is about the 
same, I will discuss the whole subject under the head of hip- 
joint disease. 



THEORY AND PRACTICE OF MEDICINE. 227 

flORBUS cox^. 

HIP-JOINT DISEASE. 

This disease is characterized by inflammation of the bones 
of the hip-joint, occurring in the scrofulous diathesis. 

Symptoms. — The child is noticed to fall easily, and 
finally begins to limp, and complains of pain in the knee, but 
usually there is no tenderness there, but if the hip be exam- 
ined it will be found swollen and tender. If the limb is 
extended, and a slight tap is made on the heel, then the pa- 
tient will tell you that it hurts in the hip-joint As the 
disease advances the pain becomes intense. If the disease is 
not arrested at this stage, an abscess will be formed, and caries 
or death of bone, will be the result. After an abscess forms 
and breaks, then the bones begin to disintegrate, and come 
away in small pieces, which may take months or years, to 
heal. When caries takes place, the hip shrinks and the joint 
is displaced upward, and the limb is shortened. 

Diagnosis. — Rheumatism is the only disease that sim- 
ulates inflammation of bone. The latter is circumscribed, 
while the former is more diffused. And then again, rheuma- 
tism is apt to manifest itself in other parts of the body. If 
the urine and excretions are strongly acid, then we know that 
the case is rheumatism. 

Prognosis. — Formerly this has been a very fatal disease. 
My experience in homoeopathy warrants me in saying, that 
a majority of cases of threatened caries may be arrested by 
homoeopathic treatment, if taken in the incipiency of the dis- 
ease, and but few need to die, if properly treated, even after 
the bones become affected. 

Causes. — Injury of the periosteum of bones, may cause 
inflammation, but usually caries is the result of a scrofulous 
diathesis, and yet patients may remain in that condition dur- 
ing a long life-time, without the disease being developed. 
But, if he should take cold, or receive a blow, then the dis<- 
eased condition may supervene which ends in caries. 



228 THEORY AND PRACTICE OF MEDICINE. 

Treatment. — The object in the treatment must be to 
arrest the disease in its incipiency, and prevent an abscess and 
caries. I am aware that well selected homoeopathic remedies 
ought to cure all curable cases without external applications, 
and yet, when they can be used without hindering the action 
of the internal remedies, then I claim that we ought to use 
them in such a grave and deforming disease as caries. I am 
satisfied that the following has helped to arrest many cases in 
their incipiency : tincture iodine, one ounce ; tincture aconite, 
half ounce ; tincture belladonna, half ounce. Mix and apply 
to external parts two or three times a day. It lessens the 
pain, and by its penetrating properties it absorbs the infiltrated 
serum, which precedes inflammation and the formation of an 
abscess. 

To allay febrile excitement, and ease pain, aconite 3X may 
be given internally, from one to two hours. As soon as the 
febrile excitement begins to abate, then I regard biniodide of 
mercury as the sheet-anchor for the scrofulous struma, and to 
arrest disease of bone. 

Silicea must soon follow the biniodide to prevent or arrest 
caries, which it does in a surprising manner. Hepar sulphur 
may be used high with the view of arresting the suppurative 
process. 

Rhus tox. is an invaluable remedy for coxalgia (pain in the 
hip joint), with involuntary limping, pains felt mostly in the 
knee, and worse from exertion. If an abscess forms it should 
be opened early or aspirated. 

After an abscess has formed, our main reliance must be 
arsenicum for burning pain with prostration ; calcarea carb., 
to overcome the scrofulous diathesis, and assist in the healing 
of abscesses. China for excessive prostration, after the open- 
ing of an abscess. Silicea should only be omitted a few days 
at a time, for the administration of any indicated remedy, foi 
I regard it as the sheet-anchor for arresting caries, and hard- 
ening the inflamed bones. 

Rest and extension of the limb should be enjoined until 



THEORY AND PRACTICE OF MEDICINE. 229 

the acute stage has passed. This can be obtained by a proper 
brace, so as not to press hard upon the tender bone. As soon 
as possible after the patient has rallied from the acute symp- 
toms, he should be allowed to have out-door exercise in a 
carriage, provided the brace can protect the joint, and keep it 
at rest. The same diet, etc., as recommended for scrofula 
should be enjoined. 

RACHITIS. 

RICKETS. 

This disease belongs to the scrofulous diathesis, and the 
word comes from wrick, which means to twist, and hence it 
means a twisting or distortion of the bones. The word proba- 
bly should be spelt wrickets. 

The disease belongs to early childhood, all of the bones 
are liable to be affected. There is a deficiency of earthy 
matter in the bones. 

Symptoms. — The child looks delicate and languid. 
There is generally a profuse perspiration on the head, and 
upper part of the chest. The child has an unsteady gate as 
though the bones could hardly support the body. The gen- 
eral symptoms are those belonging to the scrofulous diathesis. 
The mental faculties are generally above the average. Den- 
tition goes on slowly, and the teeth soon become loose and 
carious ; the fontanelles and sutures are usually open, the head 
large, and the forehead prominent ; the chest flattened at the 
sides, and the sternum projecting ; the epiphyses of the long- 
bones become spongy, and the joints swell. This is commonly- 
first perceived in the wrists and ankles. As the disease ad- 
vances, the long bones yield to the weight of the body, and are 
twisted by the action of the muscles ; the vertebrae are forcedi 
from their places, and the child becomes hump-backed. 

Causes. — The scrofulous diathesis, poor diet, and a want 
of cleanliness and pure air. 

Prognosis. — While it creates great deformity it is rarely 
fatal unless complicated. 



230 THEORY AND PRACTICE OF MEDICINE. 

Pathology. — There is a want of assimilation, and a 
deficiency of phosphate of lime in the bones. 

Treatment. — The child must be treated by the general 
plan, as laid down under the head of scrofula — a nourishing 
diet of milk, fresh meats, malted milk, etc. The child should 
have plenty of out-door exercise, and if necessary be supported 
by braces. 

Phosphoric acid. — This is regarded as a valuable remedy 
for rickety children. 

Calcarea phos. promotes assimilation and corrects deficient 
consolidation of bone. Ferrum is also a valuable remedy. 

Silicea. — This is probably the best agent we have to arrest 
the perspiration of the upper part of the chest, and to harden 
the bones and prevent caries. 

A warm climate with a sandy soil is the best residence for 
scrofulous persons. 

RHEUflATISM. 

This is a constitutional disease, and may be either acute, 
subacute, or chronic, articular, and muscular. 

Acute Rheumatism. — This disease is often ushered in 
with a high grade of fever, with intense pain in either of the 
joints or muscles. When the joints are involved then it is 
called articular rheumatism, but if only the muscles are in- 
volved it is called muscular rheumatism. Articular rheuma- 
tism does not affect the heart by metastasis like the muscular. 
Rheumatism is erratic, that is, it is liable to shift from place 
to place in a short period of time. The skin, and every tissue 
in the body, are liable to attacks. Rheumatism of the skin 
has a pain like the sting of a bee. The fever is high and of 
the sthenic grade, pulse ranging from 90 to 120 per minute. 
Temperature ranges from 102 ° to 104 . If it rises to 105 ° it 
is a grave symptom. The pain is intense and the parts often 
swollen ; the patient cannot bear to be touched, even walking 



THEORY AND PRACTICE OF MEDICINE. 23 1 

through the room causes great pain to the patient. Subacute 
rheumatism is characterized by a milder type of fever. 

Chronic Rheumatism. — This may follow an acute attack, 
or come on gradually. There is but little or no fever. While 
the pain is not so acute yet it is often intense. 

Pathology. — There is often metastasis of muscular rheu- 
matism to the heart, producing endocarditis and pericarditis ; 
also to the brain, producing meningitis ; the stomach is often 
inflamed, and the joints are often left thickened and anchylosed. 

Causes. — The predisposing causes are a hereditary dia- 
thesis, and the hyperplastic or acid diathesis. Rheumatism 
cannot exist in any other condition of system. 

Nature is often making an effort to get rid of the super- 
abundance of acids in the system by throwing them off in 
copious perspirations, while in that relaxed condition, if the 
patient is exposed to a direct draft of cold air, or by getting 
the body and feet wet, then the elimination of acid is suddenly 
checked, and a congestion and an inflammatory condition is 
set up in the tissues. 

Diagnosis. — The diagnosis of rheumatism is generally 
easy. The stiffness of the muscles and joints with pain, dis- 
tinguish this disease from all others. Sometimes but one joint 
may be swollen, red and painful ; in that case you are at a loss 
to know whether it is a scrofulous inflammation of the joint, 
or whether it is a case of rheumatism. In that case your diag- 
nosis must be guarded for a few days, for if it is a case of rheu- 
matism it will develop in other joints. If you test the urine 
of the patient and it is strongly alkaline, then you may be sure 
that it is a case of erysipelatous inflammation, or scrofula. But 
if the urine is strongly acid then you need not hesitate to pro- 
nounce it rheumatism. 

Prognosis. — In some epidemics, rheumatism is often 
fatal, more generally by metastasis to the heart or brain. But 
if the patient is seen in time, it is rare that they die under 
homoeopathic treatment. And then again, if they are judi- 



232 THEORY AND PRACTICE OF MEDICINE. 

ciously treated by homoeopaths, they are never left stiff and 
crippled. 

Treatment of Acute Rheumatism. — Aconite and 
veratrum viride are the first remedies to be thought of in the 
fever of acute rheumatism, and sometimes they cure the case 
without any other remedy. 

Aconite is indicated, aside from the fever, when there is 
red swelling of the affected part, very sensitive to contact and 
motion ; stitching pains in the chest, hindering respiration. 

Veratrum viride is not only indicated for the fever, but 
also when the left shoulder, hip, and knee are involved, 
also for rheumatic endocarditis and pericarditis. As the 
treatment of acute and chronic rheumatism are the same 
after the fever abates, I will continue the treatment under the 
head of chronic rheumatism. 

Diet. — The patient should be allowed animal food only 
in such quantities as to keep up the patient's strength, as it 
only increases the hyperplasticity of the tissues. Vegetable 
soup, oat-meal, cracked wheat, barley, and rice may be al- 
lowed freely, as they have a tendency to neutralize the acid 
condition of system. Lemonade is a grateful drink, and may 
be taken ad libitum, for lemon-juice is an antidote to the uric 
acid diathesis, which furnishes the fruitful soil in which rheu- 
matism is developed. You must remember that lemon-juice 
is composed of water, mucilage, and citric acid. Crystallized 
citric acid is composed of 35.8 per cent, of carbon, 4.5 hydro- 
gen, 59.7 oxygen; and when taken into the stomach, the 
vegetable acid is consumed by digestion, and the carbon, hy- 
drogen, and oxygen are set free. The oxygen having an 
affinity for the uric acid of the urine, unites with it, and thus 
produces a chemical change by which urea is set free, and 
carbonic acid is evolved, and thus the uric acid diathesis is 
antidoted. By dry distillation uric acid is decomposed, and 
carbonate of ammonia, urea, cyanuric acid, and hydrocyanic 
acid are found to be its component parts. Urea is an organic 



THEORY AND PRACTICE OF MEDICINE. 233 

matter, which is a constituent of urine. It would be a very 
pleasant task to carry our investigation a little further, if it 
was profitable, and ascertain what element or elements are at 
work in the urine, by which a chemical change takes place, 
so as to produce carbonate of ammonia, cyanuric and hydro- 
cyanic acids, and cause their union with urea by which uric 
acid is evolved. Many kinds of fruit are valuable agents to 
assist in overcoming the rheumatic, or acid diathesis ; grapes 
are especially used for this purpose. Grapes contain tartaric 
acid, and when taken into the stomach, the vegetable acid is 
consumed by digestion, and the potash is set free to antidote 
the acid condition of the system. 

Local applications are often advisable to relieve the suffer- 
ing; hot bricks rolled in flannel cloths saturated with vine- 
gar, and placed near the limb, and covered with a dry blanket, 
often give great relief. The affected limb may be incased in 
cotton-batting and dry flannel. You should never use lini- 
ments on rheumatic limbs, for fear of driving the disease to 
the heart, and other internal organs. 

Treatment of Subacute and Chronic Rheumatism. 
— After the febrile stage has been somewhat abated, then, as 
a rule, bryonia and rhus tox. are indicated more than any others 
for general rheumatism. Bryonia is called for when the joints 
are swollen and painful, and the patient wants to remain per- 
fectly quiet, as he is always worse while moving, and continues 
to suffer until he is brought to rest. 

Rhus tox.— Patient is worse while at rest, and wants to be 
constantly changing his position. He is worse when he begins 
to move, but grows better from continuous exercise — the re- 
verse of bryonia. 

Having called your attention to the general treatment of 
rheumatism, I now direct your mind to the consideration of 
the special treatment of the various symptoms of rheumatism ; 
and I remark that each particular locality calls for a special 
remedy. 



234 THEORY AND PRACTICE OF MEDICINE. 

It was once supposed that rheumatism only affected the 
muscles and ligaments of joints ; but now it is known to attack 
every tissue of the body. Rheumatism of the skin produces 
pain resembling that caused by the sting of a bee. As a rule 
pure rheumatism attacks the body of the muscle, while neu- 
ralgia is a disease of the nerve ; but we sometimes meet with 
cases in which the pain is not intense enough for neuralgia, 
and yet the symptoms do not point to pure rheumatism ; such 
cases we denominate rheumatic neuralgia. That is to say a 
disease of the sheath of the nerve and the sheath of the mus- 
cle, neither pure rheumatism nor neuralgia proper. 

Abrotanum. — Pain in hands, wrists, elbows, and shoulders. 

Apis. — Rheumatism of the skin, like the sting of a bee. 

Arnica. — Patient feels lame as though he had been bruised, 
and the couch feels hard ; he warns persons not to touch his 
limb. 

Arsenicum. — The pain is tearing, burning and stinging ; 
application of warmth relieves the pain ; extreme thirst, drink- 
ing little and often. 

Belladonna. — Is indicated for frequent darting pains from 
the joint along the limb ; also for bright redness of the joints, 
with dry hot skin ; patient is sleepy but cannot sleep. 

Cactus grandiflorus. — This is a grand remedy for rheuma- 
tism of the heart ; patient is worse lying on the left side. 

Caulophyllum. — Rheumatism of the wrists and finger- 
joints, with much swelling ; also of the back and nape of the 
neck, with rigidity of the muscles. 

Chamomilla. — Patient becomes almost furious about the 
pains, can hardly endure them. Redness of one cheek, and 
paleness of the other. 

Chelidonium. — Rheumatic swelling, with a stone-like hard- 
ness of the affected parts ; constant pain under the lower, inner 
angle of the right shoulder-blade. 

Cimicifuga. — Articular rheumatism of the lower extremi- 
ties, with much swelling and heat of the parts ; pains worse 
from motion, extorting screams. 



THEORY AND PRACTICE OF MEDICINE. 235 

Colchicum. — Chilliness even near the hot stove, intermin- 
gled with flashes of heat ; metastasis to the heart, with stitches 
and tearing in the chest and region of the heart ; strong and 
fluttering beating of the heart ; profuse sour-smelling per- 
spiration. 

Dulcamara. — This remedy is indicated when rheumatism 
is produced by damp stormy weather. 

Kali hydriodicum. — Is indicated for enlargement of the 
joints, stiffness, and affection of the periosteum ; movement of 
the patient causes intense pain in the lumbar vertebrae. 

Kresotum. — Pain in hip and knee-joints, ulcerative pain in 
soles of feet. 

Lachesis. — Swelling of the index finger and wrist-joint ; 
patient worse after sleeping. 

Ledum. — Rheumatic pains in hip and knee-joints, and 
when it commences from below and goes upward. 

Phytolacca. — This is an invaluable remedy in nearly all 
forms of chronic rheumatism. 

Pulsatilla. — Pains which shift rapidly from one part to 
another ; chilliness even in a warm room ; craves cold, fresh 
air ; feels worse in a warm temperature ; persons of a mild, 
tearful disposition. 

Rhododendron. — Has drawing, tearing pains in the joints 
and limbs ; pains worse during rest, and in rough, stormy 
weather ; swelling and redness of single joints ; rheumatism 
of the knee. 

Spigelia. — Dull stitches in the region of the heart ; vio- 
lent palpitation of the heart, with great anxiety ; dispnoea ; he 
can lie only on the right side, with trunk raised ; the least 
motion produces great suffocation. 

Veratrum album. — Pains like electric jerks in the affected 
limbs. 

You must remember that muscular rheumatism scarcely 
ever produces redness and swelling. There is more danger of 
metastasis to the heart in muscular rheumatism, than from 
the articular variety. There are some forms of muscular 



236 THEORY AND PRACTICE OF MEDICINE. 

rheumatism, that receive their nomenclature from the muscles 
affected. I will mention some of them, and give you their 
indicated remedies. 

Stiff-Neck or Crick-in-the-Neck. — This affection is 
characterised by excruciating pain when attempting to turn 
the head. The muscles become swollen, hard, and rigid. 
Sometimes the pain extends to the articulations of the clav- 
icle and intercostal muscles. 

Treatment. — Aconite, belladonna, antimonium tartari- 
cum, and dulcamara, are the usual remedies used in this 
affection. 

Aconite from cold ; belladonna has pain in the nape of 
neck ; antimonium tart., has cramping pain in the muscles of 
the neck ; dulcamara is indicated when the crick-in-the-neck 
is produced by damp weather. 

Pleurodynia. — This is a rheumatic inflammation of the 
intercostal muscles, and those lining the walls of the chest. 
It more frequently occurs on the left side. It is sometimes 
called false pleurisy, because the pain resembles that of pleu- 
risy, but it has no connection with that disease. You must 
not make a mistake between this disease and that of per- 
icarditis. 

The pain in pleurodynia is increased by motion, and deep 
inspiration, and it is sharp, like as if an instrument pierced 
the side. The want of fever, cough, and deep seated pain, 
distinguishes pleurodynia from pleurisy. The sounds of the 
heart will distinguish it from pericarditis and endocarditis. 

Treatment. — Arnica, asclepias, tuber osa, cimicifuga, 
and ranunculus bulbosus. 

Lumbago. — This, as its name implies, is rheumatism of 
the lumbar muscles. The pain is sometimes intense. If the 
patient attempts to arise from his chair or couch, he is sud- 
denly seized with a severe stitch in the lumbar region which 



THEORY AND PRACTICE OF MEDICINE. 237 

would cause him to fall, unless he had some support. The 
least exertion causes pain, but by continuous exertion the 
pain is relieved. The sudden crick in the region of the lum- 
bar muscles, distinguishes lumbago from all other pains in the 
back. 

Treatment. — Aconite is beneficial if lumbago is pres- 
ent in an acute attack of rheumatism. 

Antimonium tartaricum is indicated when patient is worse 
on moving; occasional cramps, with nausea, and cold per- 
spiration. 

Arnica. — Is indicated when lumbago follows an injury to 
the lumbar muscles. 

Cimicifuga. — This is a valuable remedy when rheumatism 
attacks the muscles of the back. 

Kresotum. — This is an invaluable remedy when the pain 
is of a burning character, and is worse during rest, better from 
motion. 

Phytolacca. — Is indicated for chronic lumbago. 

Bryonia. — This agent is not laid down among the reme- 
dies for lumbago, but it is, nevertheless, the agent par excel- 
lence for lumbago which is worse from motion, and continues 
to grow worse until rest is procured. 

Rhus tox. — This remedy produces lumbago ; after exposure 
to wet weather; the patient is worse at night after repose, 
pain severe when beginning to move, but is relieved by con- 
tinuous motion. 

Equal parts of the oil of wintergreen and olive oil, make a 
valuable liniment for lumbago. Wintergreen contains sali- 
cylic acid. By applying a piece of flannel to the back, and 
then ironing the patient well with a warm flat-iron, sometimes 
gives great relief. 

Sciatica. — This is a form of rheumatism in which the 
sheath of the sciatic nerve, and the sheath of the gluteal mus- 
cles are involved. The pain is not so excruciating as that of 
neuralgia and of rheumatism of the joints. Therefore, as it 



238 THEORY AND PRACTICE OF MEDICINE. 

is neither neuralgia nor rheumatism proper, it may be termed 
rheumatic-neuralgia. The pain is of a sore, aching, darting 
nature, often preventing the patient from walking. The pain 
and soreness often extend from the nates to the knee and some- 
times to the ankle. There is scarcely any redness of swelling, 
and yet the soreness and pain seem to indicate that there must 
be an inflammatory action going on. 

Treatment. — Aconite must be given to allay febrile ex- 
citement ; it often performs a cure without any other remedy. 
But sometimes it is a very annoying and troublesome affection 
to get rid of. 

Arsenicum. — Is indicated where there is great pain extend- 
ing along the track of the sciatic nerve from the hip to the 
knee and ankle. 

Colocynth. — This agent produces shooting pain, like light- 
ning, down the whole limb and crest of ilium. 

Phytolacca. — Chronic sciatica ; pains shooting from sacrum 
down outside of both hips. 

Pulsatilla. — Jerking pain in hip-joint, extending to knee. 

Rhus tox. — Is indicated for sciatica, right side, dull, aching 
pain, worse at rest, and during damp cold weather ; patient 
feels worse when moving and yet he cannot keep still. 

GOUT— Podagra. 

Podagra means gout in the feet It is a disease similar to 
rheumatism, and it may be either acute or chronic. 

Causes. — The predisposing cause is a hereditary diathe- 
sis ; or it may be acquired by increasing a hyperplastic condi- 
tion of system. The exciting causes are wine and malt liquors, 
and an excess of animal food. It is supposed that an excess 
of uric acid in the blood causes a deposit of urate of soda in 
the smaller joints, which causes redness, swelling and pain. 
It is a singular fact that high livers who drink wine and beer 
are subjects of gout, while those who drink whisky and live 
on coarse diet are subject to rheumatism. 



THEORY AND PRACTICE OF MEDICINE. 239 

Symptoms. — A person may retire at night apparently 
well, and be aronsed towards morning with intense pain in one 
or both great toes. They are found sensitive, red, swollen and 
very painful, as a result of indigestion induced by a debauch 
of rich food, wine and beer. There is more or less fever, and 
the hands and feet are hot and painful. The patient can 
hardly find rest in any position during the night, but is better 
during the day. Unless the case is properly treated, and the 
diathesis is changed, the disease becomes chronic, and the 
patient is troubled more or less during life. The joints become 
enlarged by the deposit of urate of soda, called chalk stones. 

Diagnosis. — Gout first attacks the small joints, especi- 
ally the ball of the great toes, and the disease may spread to 
the larger joints. Rheumatism at first attacks the muscles 
and large joints, and then may spread to the smaller ones. 
Gout generally attacks men from thirty-five to fifty years of 
age. It is rare in women. Rheumatism may attack any age, 
but more generally from twenty to thirty years of age, and 
affects men and women alike. 

Treatment. — You will have to be very careful in the 
treatment of gout, for if you use liniments or cold applications 
you may drive the disease to some of the internal organs, 
when you will have irregular gout to contend with. 

Aconite. — This remedy is indicated for the fever, pain and 
restlessness. To give temporary relief you can saturate flan- 
nel cloths in strong vinegar, and roll around warm bricks, and 
lay close to the joints, and cover with dry blankets, so as to 
retain the warm vapor. After the first stage of acute gout 
has been abated, then the following treatment is applicable, 
both for acute and chronic gout. In order to overcome the 
gouty diathesis, you must overcome indigestion, and the 
hyperplastic diathesis. This is accomplished by medicines 
and a regulation of the patient's diet, which must consist, 
principally, of vegetables, with a small amount of animal diet. 
He should give up wine and beer, and irregular meals or 
luncheons. 



240 THEORY AND PRACTICE OF MEDICINE. 

Bryonia. — Pain in the feet, as if sprained ; pain on motion 
and turning the foot, as also from touch. 

Colchicum. — This remedy is almost specific. It is indi- 
cated by tearing pain in toes ; tingling in toes, like after be- 
ing frosted. 

Gelsemium. — Drawing, crampy pains in toes. 

Kali iodatum. — Ulcerative pain in heels and toes, more es- 
pecially for chronic gout, or syphilitic gout. 

Ledum palustre. — Gout worse in feet ; gouty nodosities on 
the joints ; fine tearing in the toes ; pains in soles of the feet, 
as if bruised, when walking. 

Nux Vomica. — Darting pains from toes to hip. 

Pulsatilla. — Feet red, inflamed, swollen ; also the toes. 
Swelling of the top of the foot. 

Robinia. — Excessive acidity of the stomach and tissues. 

When the larger joints become involved, then you must 
treat the case similarly to that of rheumatism, which is some- 
times called rheumatic-gout. You must look to the remedies 
under indigestion to overcome dyspeptic symptoms. When 
the brain, heart, stomach, etc., become involved, you must 
select the remedies that are called for by the symptoms de- 
veloped in those organs. 

DRY JOINTS. 

Camphor. — Cracking and creaking in the hip, knee and 
ankle-joints. 

Chamomilla. — Creaking of joints. 

Cocculus. — Cracking in the knees when moving, cracking 
and creaking in the joints. 

Crocus saliva. — Violent cracking of the hip or knee-joint 
when stooping. 

Nux vo7nica. — Knee-joints feel dry with cracking when 
moving. Arthritic inflammation of the knees, also with 
nodosities. 

Thuja. — Joints crack when limb is stretched ; nails brit- 
tle or soft. 



THEORY AND PRACTICE OF MEDICINE. 241 

FEET. 

When over-exercise causes the feet to become sore or blis- 
tered, then argentum met. and cantharis are beneficial. But 
probably nothing equals arnica, internally, and as a wash. I 
have prescribed this for base-ball players with fine results. 

If the feet are burning and tender so that the patient can 
scarcely walk, then ca?ttharis, carbo veg., and phosphorus are 
valuable remedies. 

CHILBLAINS. 

FROSTED FEET. 

If seen in time rub with ice or snow. If the feet are in- 
flamed, belladonna, veratrum viride and rhus tox., are the indi- 
cated remedies. 

If the blisters are broken, petroleum, agaricus, rhus tox. 
internally, and calendula lotion are our main reliance. 

If the feet are ulcerated arsenicum, kreasotum (creasote), 
petroleum and phosphorus, internally, and the calendula wash — 
ten to twenty drops to a goblet of water — will usually relieve. 
If there is a tendency for the trouble to return then calcarea 
carb., phosphorus, Pulsatilla and sulphur, should be given as 
the indications demand. 

If there is a tendency to cold feet with hot hands and face, 
sulphur is indicated. Ferrum, Pulsatilla, sepia, and silicea 
may give good results. 

16 



242 THEORY AND PRACTICE OF MEDICINE. 



LOCAL DISEASES. 

Respiratory System, 
Circulatory System, 
Digestive System, 
Biliary System, 

Phlegmasia < Secretory System, 

Urinary System, 
Nervous System, 
Cutaneous System, 
Generative System. 

RESPIRATORY SYSTEM. 

Catarrhus, Catarrh. 

Catarrhus Epidemicus, Influenza or Grippe. 

Laryngitis, Inflammation of Larynx. 

Tracheitis, Croup. 

Laryngitis Stridulus, Spasmodic Croup. 

Bronchitis, Inflammation of the Bronchi. 

Asthma, Asthmatic. 

Pneumonitis, Inflammation of the Lungs. 

Pleuritis, Inflammation of the Pleura. 

Cynanche Thyroidea, Bronrhnrele — Goitre. 

Pertussus, Whooping Cough. 



CATARRHUS. 

CATARRH. 

This is an affection of the whole mucous membrane ex- 
tending from the Schneiderian membrane to the bronchi. It is 
an irritation, or a subacute inflammation, which produces a 
stuffing sensation of the nose and air-passages. These pas- 
sages are sometimes dry, or they may discharge a thin mucus. 
This condition is commonly called a cold, and has received 
names in accordance with the parts affected, which I will now 
take up in regular order. 



THEORY AND PRACTICE OF MEDICINE. 243 

CORYZA. 

COLD IN THE HEAD. 

When catarrh is confined to the mucous membranes of the 
eyes and nostrils, it is called coryza, or cold in the head. 

Symptoms. — This condition is ushered in by headache, 
pain in the back, and limbs ; the patient complains of feeling 
chilly ; sometimes there are slight rigors, followed by sneez- 
ing with a thin acrid discharge from the nose. The eyes 
are red and watery ; sores often form about the nose and lips. 
If the irritation extends to the mucous membranes of the 
trachea and bronchi, then the patient will be annoyed with a 
hacking cough, and sometimes the cough may be hard and 
deep. This affection may be acute or chronic. When chronic 
it is called nasal catarrh. 

Treatment. — Coryza, or acute nasal catarrh, requires 
aconite^ arsenicum, camphor, dulcamara, and gelsemium. 

Camphor is indicated during the cold stage. 

Aconite is called for when there is violent sneezing, fever, 
thirst, restlessness ; dry or fluent coryza caused by dry, cold 
air or wind. 

Arsenicum. — This remedy is indicated for frequent sneez- 
ing, with hoarseness, sleeplessness, watery discharge causing 
burning, and smarting at nostrils, as if sore. 

Dulcamara. — Catarrh produced by damp chilly weather 
calls for dulcamara; the patient is better during motion; 
worse during rest ; skin hot and dry, limbs cold, stiff, numb 
and painful. 

Gelsemium. — Has violent morning paroxysms of sneezing ; 
watery discharge excoriating the nose ; there is a feeling as 
though a stream of scalding water was passing from the throat 
into the nostril. 

Euphrasia is an excellent remedy for acrid fluent coryza, 
profuse lachrymation and redness of the conjunctiva. 



244 THEORY AND PRACTICE OF MEDICINE. 

Chronic Nasal Catarrh. — I need not take up your 
time in rehearsing the symptoms of nasal catarrh, for as I re- 
peat the remedies you will see by their indications what the 
symptoms are that call for each. 

Kali bichromtcum. — Is called for when the discharge, from 
the nose and posterior nares, is ropy and tough, sometimes 
offensive. 

Mercurius iodatus ruber. — Whitish-yellow, or bloody dis- 
charge ; affection of posterior nares, with raw sensation ; nasal 
bones diseased, turbinated bones swollen ; hawks much mucus 
from posterior nares. 

Pulsatilla. — Has green, fetid, nasal discharge, with dimin- 
ished taste and smell ; sometimes yellow discharge ; worse in 
doors. 

Sepia. — Is indicated when the patient blows large lumps 
of yellow-green mucus or yellow-green crusts with blood, 
from the nose ; painful eruption on tip of nose. 

Sulphur. — Produces a smell before the nose as from an old 
catarrh ; bloody discharge when blowing the nose ; dry ulcers, 
or scabs in nose. 

There is sometimes an intolerable odor arising from an old 
chronic case of nasal catarrh. In order to overcome this until 
your medicines have time to arrest the progress of the disease, 
you can spray the nostrils and posterior nares with a solution 
of permanganate of potash, from five to ten grains to an ounce 
of water. The spray can be used once or twice a day, owing 
to the amount of odor. 

CATARRHUS EPIDEniCUS. 

INFLUENZA OR GRIPPE. 

Symptoms. — This epidemic disease begins with symp- 
toms resembling common colds, only much more aggravated. 
The sneezing and pain in the head are much more intense. 
The tonsils and fauces are inflamed, there is frequent short 
cough, but sometimes it is harrassing. The expectoration is 



THEORY AND PRACTICE OF MEDICINE. 245 

thick and viscid, but becomes mucopurulent. There is loss of 
appetite, the skin is hot and dry, pulse small and frequent ; pa- 
tient complains of a sore, tired feeling ; he often becomes pros- 
trated from the beginning of the attack. Some epidemics are 
prone to complications ; there may be a tendency to inflamma- 
tion of the brain or its membranes, bronchitis, pneumonia, ton- 
silitis, diarrhea, dysentery, erysipelas, and a typhoid condition. 

Diagnosis. — From common or sporadic catarrh owing 
to its rapid spread in the community, and its prostrating in- 
fluence from the beginning. 

Prognosis. — It is rarely fatal in the young and robust, 
but often very fatal to the aged and delicate. 

Causes. — The disease is epidemic, and is produced by a 
peculiar atmosphere. Cold damp weather is prolific of the 
spread of this disease. 

This disease was called influenza by the Italians in the 
seventeenth century, because they thought it was influenced 
by the stars. It is now called grippe. 

Treatment. — The treatment of uncomplicated influ- 
enza in the first stage is similar to that of simple acute catarrh. 
Camphor in the chilly or cold stage, aconite in the febrile 
stage, and for coryza. As the patient generally feels pros- 
trated from the beginning, arsenicum is an indicated remedy, 
especially when there is much sneezing, with hoarseness and 
watery discharge excoriating the nostrils. 

As no two epidemics are just alike, or no two patients are 
affected in the same way, you will have to become familiar with 
the remedies, in order to be able to treat each case separately. 
After the premonitory symptoms of grippe have lasted a 
longer or shorter time, then the brain, lungs, stomach, bowels,, 
and kidneys, may become involved, and typhoid symptoms; 
are developed in some. So you see how difficult it is to lay 
down any positive rules for the treatment of grippe, as ex- 
pressed in a name. Hence, I will give you a few of the 
remedies, that I have found to be most beneficial in the vari- 
ous forms of that disease. 



246 THEORY AND PRACTICE OF MEDICINE. 

Baptisia is called for when any symptoms of typhoid are 
present, known by the offensive odor arising from the secre- 
tions, and prostration of the patient. 

Belladonna has headache, hacking cough, and soreness of 
the chest. 

Bryonia has a prostrated, tired feeling, aversion to motion, 
either mental or physical ; a deep harassing cough. 

Eiipatorium perfoliatum is called for when every bone in 
the body seems to be painful. That is to say, the periosteum 
seems to be* affected. 

Kali bichromicum is called for when cough is troublesome 
and the sputa stringy. 

Gelsemium has, in addition to sneezing, a tired feeling 
similar to that of bryonia, also pain in the back of the head. 

Phosphorus is indicated for cough, hoarseness and pain in 
the left side. 

Rhus tox. is called for when patient is restless, and wants 
to move the limbs frequently ; there is a sore rheumatic feel- 
ing of the limbs. 

Diet. — This should consist of liquid alimentation, such 
as extract of beef, milk, and soft eggs. The most important 
point to be observed is rest in bed, until the grave symptoms 
have passed. If the patient requires stimulants, then several 
goblets of fluid beef extract per day, is the best stimulant he 
can have. The patient should be kept comfortably warm, 
and his room well ventilated. 

LARYNGITIS. 

INFLAMMATION OF THE LARYNX. 

Laryngitis may be acute and chronic. 

Symptoms of Acute Laryngitis. — The patient first 
complains of a raw, or rough feeling in the larynx, followed 
by a slight chill, or rigors, lasting a longer or shorter time, 
when fever sets in. The voice becomes hoarse and husky, 
the larynx becomes painful, especially by pressure. The 



THEORY AND PRACTICE OF MEDICINE. 247 

throat becomes constricted, the respiration difficult and sonor- 
ous ; the act of swallowing becomes painful, the tonsils and 
fauces are red and swollen. These symptoms are often fol- 
lowed by those of a more grave character. The countenance 
becomes pale and anxious ; the lips livid ; the eyes suffused ; 
the nostrils expanded ; the pulse frequent, feeble, and irregu- 
lar ; the voice reduced to a whisper, or lost ; the throat often 
edematous. There is extreme restlessness ; urgent fear of 
suffocation ; sleeplessness, or if the patient dozes, he awakes 
in a dreadful agitation, gasping and struggling for breath. 
Delirium and coma ensue, and death takes place in from four 
to five days, or the patient dies at an earlier period — asphyx- 
iated. 

Pathology. — The lining membrane of the larynx is 
thickened, with edema of the submucous cellular tissue ; the 
glottis and epiglottis red and swollen, and containing serum, 
sero-purulent fluid or pus. In some cases edema of the 
glottis is the only post-mortem appearance. 

Causes. — Predisposing. — Intemperance, abuse of mer- 
cury, frequent and long continued exertions of the voice ; the 
adult age. 

Exciting. — Exposure to wet and cold ; extension of in- 
flammation from the tonsils or salivary glands ; swallowing 
scalding or corrosive liquids ; inhaling acrid gases or hot air ; 
extension of inflammation in erysipelas, scarlatina, small-pox, 
and measles. 

Diagnosis. — The only disease that is likely to confuse 
you is spasm of the larynx, but the absence of pain and fever 
distinguish this affection from laryngitis. When tracheitis, or 
true membranous croup, extends to the larynx, then it is im- 
possible to tell whether it is tracheitis or laryngitis. But upon 
a careful examination the history of the case will reveal the 
fact that in laryngitis there is pain in the incipiency of the 
disease, while in tracheitis there is but little or no pain 
primarily. 



248 THEORY AND PRACTICE OF MEDICINE. 

Prognosis. — It is a very fatal disease, but fortunately it 
is of rare occurrence. You should be thoroughly posted on 
the treatment and diagnosis, for if seen in time, and diagnosed 
early, then homoeopathy can sometimes produce wonderful 
results. 

Treatment. — The treatment in acute laryngitis must be 
prompt, in order to accomplish any good results. Aconite in 
alternation with spongia are the best agents in the first stage. 
You have no time to lose in discussing the one remedy theory, 
for while you are hesitating which remedy to give, the golden 
opportunity may have passed in which to save your patient. 
Always give your patient the benefit of a doubt whether it 
coincides with theory or not. 

Apis. — Has hoarseness, dryness and burning of the larynx, 
and edema of the glottis. 

Kali bichromicum. — Is called for in laryngitis when there is 
a tendency to the formation of a diphtheritic membrane, known 
by the hoarse metallic sound. 

Lachesis is indicated for hoarseness, rawness and dryness 
of the larynx, which is sensitive to the touch ; the least touch 
causes suffocation. 

Treatment of Chronic Laryngitis. — Some of the 
same remedies, that are called for in acute laryngitis are used 
in the treatment of the chronic disease ; but you must remem- 
ber that while a certain train of symptoms may call for a cer- 
tain remedy in one patient, yet the next case may demand an 
entirely different remedy. 

Causticum. — Hoarseness ; worse morning and evening, 
with scraping in the throat. 

Carbo veg. — Ulcerative pain or scraping in larynx ; feel- 
ing of dryness in trachea, not relieved by hawking. 

Hepar sulphur. — Hoarseness, roughness in the throat; 
wheezing in the larynx, and painfulness of a small spot in the 
larynx. 

Mercurius biniodatus. — Patches of inflammation, livid, 
purple, thin, offensive discharge. 



THEORY AND PRACTICE OF MEDICINE. 249 

Phosphorus. — Larynx very painful, and feels as if lined 
with fur. 

Phytolacca decandra. — Burning in larynx and trachea, 
worse towards evening ; spasm of the glottis, eyes distorted, 
one eye moves independently of the other, thumbs clenched; 
toes flexed. 

Spongia tosta. — Feeling of a plug in larynx, which is 
sore to the touch ; inflammation of larynx, trachea and 
bronchi. 

Treatment of Acute Aphonia, or Loss of Voice. — 
Bromium. — Voice husky, hoarse, cannot speak clearly, loss of 
voice ; weak and soft, with raw, scraped feeling in throat. 

Belladomia. — Voice weakened even to complete aphony ; 
dryness of the larynx. 

Biniodide of Mercury. — Complete loss of voice. 

Causticum. — The laryngeal muscles refuse their service ; 
cannot speak a loud word. 

Phosphorus. — Aphony from prolonged, loud talking ; ca- 
tarrhal or nervous ; larynx sensitive to the touch. 

Treatment of Chronic Aphony. — Carbo veg. — Aph- 
ony mornings ; in damp, cool weather. 

Hepar sulphur. — Hoarseness, or aphony, with slight suf- 
focating spasms. 

Iodine. — Tightness and constriction about the larynx, 
with soreness and hoarseness. 

Phosphorus. — Cannot talk on account of pain in the larynx ; 
it feels as if lined with fur. 

Phytolacca decandra. — Hoarseness and aphony ; dryness 
of larynx and trachea, worse towards evening. 

I have found 30X to act more beneficially than lower po- 
tencies. 



250 THEORY AND PRACTICE OF MEDICINE. 

LARYNGISriUS STRIDULUS. 

SPASMODIC CROUP. 

This disease is alarming in the adult, as well as in chil- 
dren. It comes on suddenly at night, with a spasmodic effort 
to breathe, with a hoarse croupy cough. 

Treatment. — During the attack aconite and spongia 
are called for. After the spasm has been overcome, then sam- 
bucus is indicated for a suffocative dry cough. When mucus 
accumulates, then ipecac is indicated. Kali bichromicum is 
often indicated for cough with tough, stringy expectoration. 
Sometimes a towel rung out in cold water rolled around the 
neck, and covered with dry flannel, acts like a charm. 

ANGINA TRACHEALI5. 

CROUP. 

This is a local inflammatory condition of the trachea, in- 
cluding the larynx, and is known as membranous croup, and 
inflammatory croup. 

Symptoms. — The disease begins as an ordinary cold, 
the child has a hoarse cough, for a longer or shorter time, 
when fever is developed. As the disease advances the pulse 
becomes frequent and wiry. The child becomes restless, the 
cough becomes crowing and has a metallic sound ; and as the 
disease advances the patient throws his head back, and grasps 
at his throat, and makes great effort to breathe ; he tosses 
from side to side, and death often takes place in from two to 
four days. Death is by apncea (suffocation), the lips and 
cheeks become livid, the body is covered with a cold clammy 
sweat. 

Diagnosis. — Spasmodic croup comes on suddenly. The 
child may go to bed perfectly well and be aroused suddenly 
during the night. Membranous croup begins slowly. In 
diphtheritic croup the child has fever, back and headache, with 
sore throat before the croupy cough supervenes. 



THEORY AND PRACTICE OF MEDICINE. 25 1 

Causes. — There is a hereditary tendency in some fami- 
lies for croup. Or, owing to a peculiar diathesis of certain 
children in particular localities, there is a tendency to inflam- 
matory conditions of the air passages. 

The exciting causes are cold, vicissitudes of climate and 
exposure to night air. 

Prognosis. — Membranous croup is a very fatal disease, 
and yet homceopathists can often save a great many cases. 

Spasmodic croup is rarely fatal, if seen in time. This 
fact should be explained to the people ; for if a doctor cures a 
case of croup and it is spasmodic, and loses another that is 
membranous, there may be dissatisfaction unless the parents 
understand the difference between the two varieties. 

Treatment. — The first thing to be done either in spas- 
modic or membranous croup is to saturate a towel in cold 
water and roll around the child's neck, and cover it with a dry 
piece of flannel. The first medicine to be administered in the 
early stage is aconite and spongia. 

Aconite. — Is indicated for fever with cough and loud breath- 
ing during expiration ; every expiration ending with a hoarse, 
hacking cough. 

Spongia. — This remedy has wheezing, anxious breathing, 
worse during inhalation, with whistling, sawing, between 
coughs. 

If these remedies do not give relief in a few hours, we 
must resort to the indicated remedies for membranous croup. 

I mention the remedies alphabetically, but you must scruti- 
nize the remedies and the symptoms of your patient carefully, 
and select the best indicated remedy for the stage in which 
you see the case. 

Bromium. — Gasping for breath, with wheezing and rattling 
in larynx, and spasmodic closure of glottis. 

Hepar sulphur. — Rattling, short, wheezing cough, threat- 
ening to suffocate ; must bend the head back and set up. 

Iodine. — Croupy cough, with wheezing and sawing respi- 



252 THEORY AND PRACTICE OF MEDICINE. 

ration, dry. barking cough, child grasps the throat with the 
hand. 

Kali bichromicum. — Hoarse, metallic cough, wheezing rat- 
tling in the larynx and trachea with tough, string}- expectora- 
tion. This remedy has such a powerful influence over the 
respiratory organs that I usually give it in the forming stage 
of membranous croup as soon as I am satisfied that aco?iite 
and spongia has no tendency to arrest the progress of the 
disease. 

When there is a tendency for the bronchial tubes to be- 
come involved, and there is much rattling of mucus in the 
trachea which cannot be raised, then antimonium tart, is an 
invaluable remedy. 

As a last resort, the patient may be allowed to inhale the 
fumes of iodine and slacking lime, as recommended under the 
treatment for diphtheritic croup. The bodv should be kept 
warm, and the room at a temperature of 65° F. : water-vapor 
should be kept up in the room night and day, and fresh air 
admitted continuously. Nothing but water and liquid alimen- 
tation is admissible until convalescence is established. 

Tracheotomy. — While intubation has taken the place 
of the bloody operation of tracheotomy, yet I advise all stu- 
dents to study the operation so as to be prepared to save life 
when the tubes cannot be had. It is best to be prepared for 
every emergency, yet I advise the postponing the use of tubes 
as long as there is hope from medicines. 

Hepar sulphur is supposed to be prophylactic in children 
who take cold easily and are subject to croup. 

BRONCHITIS. 

INFLAMMATION OF THE BRONCHI. 

This is an affection of the bronchial mucous membrane, 
and is characterized bv three grades of inflammation, viz.: the 
acute, subacute, and chronic. The acute is accompanied with 
high arterial excitement. The subacute has a mild grade of 



THEORY AND PRACTICE OF MEDICINE. 253 

fever ; while the chronic may continue for years without any 
fever. In infants, and the aged, the inflammation may ex- 
tend on through the tubes to the ultimate bronchial ramifica- 
tions, and thus complicate the lobules of the lungs, and 
produce what has been termed broncho-pneumonia, or capil- 
lary bronchitis. It is a little difficult to tell what authors 
mean in their division of bronchitis and pneumonia. They 
speak of acute, capillary, and chronic bronchitis ; and acute 
and chronic lobar and lobular pneumonia. There is no doubt 
that the capillary bronchitis of late writers, is the same af- 
fection that Churchill described under the head of lobular 
pneumonia of infants. We can very readily see how the 
mucous membrane of the lobules might be affected by the 
extension of the inflammation from the larger tubes, and 
therefore give symptoms similar to those of pneumonia. 
Hence, Churchill's definition, of lobular pneumonia, and 
the capillary bronchitis of late writers may be appropriate 
terms to explain the same affections occurring in children and 
the aged. I, however, will only speak of broncho-pneumonia 
in the adult as a secondary affection, induced by the exten- 
sion of the inflammation from the larger bronchial tubes, to 
their ultimate branches in the lobules of the lungs. 

I may remark here, that secondary bronchitis is almost 
always the result of some of the exanthematous diseases — es- 
pecially measles. With these remarks as to definitions, I now 
call your attention to acute bronchitis. 

Acute Bronchitis. — This disease is generally ushered 
in by catarrhal symptoms, which last a longer or shorter time 
before the fever is fully developed. The patient at first feels 
languid, the throat feels a little raw, and the breathing is a 
little rough. There are generally slight pains through the 
chest — especially at the top, and down the center of the 
sternum. There is a slight dry cough at first, and as the 
symptoms advance, the cough is troublesome ; fever is devel- 
oped, preceded by cold or chilly sensations. 



254 THEORY AND PRACTICE OF MEDICINE. 

The fever is generally sthenic, and as it reaches its acme 
the breathing becomes laborious, owing to the congested con- 
dition of the bronchial tubes. As the disease progresses, the 
mucous membrane exudes mucus streaked with blood. This 
blood comes from capillary blood-vessels, which are ruptured 
during the act of coughing. The change which the mucous 
membrane undergoes from the drv to the moist stage, gives 
rise to what are termed physical signs, and are thus classified ; 

i. Stage Dry Rhonchi (So n °rous. 

8 ' \ Sibilant. 

2. Stage Moist Rhonchi f Mucus. 

^Submucus. 

These sounds are heard by placing the ear over the rami- 
fications of the bronchi. The sound heard in the first stage is 
called the dry rale or rhonchus, and is divided into two charac- 
ters. The first is called sonorons because it is a loud harsh 
sound, and shows that the membranes are dry. The second 
is called the sibilant rhonchus, because it is a soft or hissing 
sound, and shows that the mucous membrane is becoming in- 
filtrated or growing moist. 

In the second stage we have the moist rhonchus, and this 
is divided into two sounds called the mucus and submucus. 
The mucus rale shows that the bronchi have passed from the 
dry to the moist stage. The sound is produced by the ingress 
and egress of air through mucus contained within the tubes. 
This sound is heard over the large bronchial tubes. The 
submucus rale is a milder sound than the mucus and is heard 
over the smaller tubes. 

Percussion in bronchitis always yields a clear resonant 
sound. 

Subacute Bronchitis. — I need not take up your time in 
discussing this grade of bronchitis, for it is only a milder grade 
of the acute variety. The symptoms are the same, only the 
fever is of a milder type. 



THEORY AND PRACTICE OF MEDICINE. 255 

Chronic Bronchitis. — This may follow as the result of 
an acute attack ; or it may come on so gradually that months 
may elapse before the cough and character of the disease are 
fully established. 

Sometimes the patient complains of a little sore-throat, 
which is generally dry in the beginning. Or there may be a 
little hacking cough, with an uneasy sensation in the trachea. 
But generally, after a longer or shorter period, the cough 
becomes troublesome and often harassing. 

Chronic bronchitis puts on many types. It sometimes 
simulates consumption very closely. Expectoration becomes 
copious and of a muco-purulent character ; the patient becomes 
emaciated and the pulse often becomes quick and feeble. In 
a word the general symptoms resemble those of phthisis pul- 
monalis, except the physical signs. 

I now call your especial attention to some of the stages or 
varieties of chronic bronchitis. 

1. The first type is that in which there is considerable 
cough with expectoration of dry scale-like substances inter- 
mixed with a glairy mucus. There is more or less uneasiness 
in the trachea and larger bronchial tubes. The character of 
the expectoration indicates that there are patches of the mucous 
membrane of the bronchi which are so disorganized by the 
inflammatory process as to cause concretion and exfoliation of 
the morbid product. While in other portions of the tubes 
there is an excretion of a muco-albuminous-like substance, 
which in its expulsion from the trachea carries all morbid pro- 
ducts before it, and hence the character of the expectoration. 

Sometimes when the inflammation is extensive, there are 
violent spells of coughing with no expectoration, except the 
concrete or scale-like substance of which I have already spoken. 

2. The second variety of chronic bronchitis, to which I 
call your attention is bronchorrhce. This is characterized by 
an excessive expectoration of a substance resembling the 
white of eggs. It is sometimes thrown up in large mouth- 
fuls, and is so adherent, that it resembles transparent jelly. 



256 THEORY AND PRACTICE OF MEDICINE. 

The expectoration is sometimes of a salty, sweetish, and 
musty taste. 

The patient is sometimes free from cough, but by a hawk- 
ing or expiratory effort, he is able to expectorate little trans- 
parent cylindrical or conical bodies, which resemble small fish 
bladders, or complete casts of the smaller bronchial tubes. 
At other times the patient expectorates from a few ounces to 
half a pint of muco-purulent matter daily, which tells fear- 
fully upon the vital powers. 

There is still another variety of chronic bronchitis, for 
which I know no appropriate name. The cough is hard, 
with difficult expectoration. The patient often has spells of 
coughing which last for several hours at a time, and when 
he is able to get up anything, it is of a tough, stringy char- 
acter. There are several varieties of cough, to which I need 
not now call your attention, as the indicated remedy, when 
we come to speak of the treatment, will point out the char- 
acter of the cough. 

Causes. — Acute bronchitis is undoubtedly the result of 
cold damp weather and vicissitudes of climate. Secondary 
bronchitis is induced by measles, small-pox, diphtheria, and 
other affections. Chronic bronchitis may be a sequelae of the 
acute, or it may come on gradually. 

Diagnosis. — The diagnosis of bronchitis is generally 
easy. The mucus rhonchus, and absence of dullness on per- 
cussion, distinguishes it from the hepatized condition of the 
lungs in pneumonia and tubercular deposits in phthisis pul- 
monalis. The expectoration of blood in bronchitis is clear, 
and the mucus is streaked with it ; while in pneumonia the 
blood is mixed with the mucus, giving the brick-dust sputa, 
which is diagnostic of pneumonia. 

In that form of chronic bronchitis in which the patient is 
emaciated, and has a quick pulse, and expectorates a muco- 
purulent matter, it is sometimes difficult to distinguish it 
from a case of consumption. But, if we remember that in 
consumption we first have dullness on percussion, with loss 



THEORY AND PRACTICE OF MEDICINE. 257 

of respiratory murmur, and afterwards we have pectoriloquy; 
as a result of softening of tubercular matter, and the forma- 
tion of a cavity within the lungs, then we need have no diffi- 
culty in making out a diagnosis, for in bronchitis we have no 
dullness on percussion and no pectoriloquy. 

Prognosis. — The prognosis of bronchitis is generally 
favorable in the adult ; but in children it is often a very grave 
disease. 

Treatment of Acute Bronchitis. — Aconite, anti- 
moniuni tart., kali bichromicum, bryonia, phosphorus, ipecac. 
These are the principal remedies indicated for acute bronchitis, 
and are usually called for in the order named. Aconite first 
for the fever, and antimonium tart., for the inflammation of the 
bronchi, is an invaluable remedy ; it is also called for when 
there is a loose, rattling cough, especially in capillary bron- 
chitis of children ; kali bichromicum is called for when cough 
is harassing and expectoration is stringy ; bryonia for a hard, 
deep cough ; phosphorus for hoarseness and spasmodic cough ; 
ipecac, is indicated for suffocating cough, with nausea. As you 
will have a long list of cough remedies in your materia medica 
from which to cull at pleasure, I need not mention any more 
at present. The subacute bronchitis requires the same treat- 
ment as the acute. 

Treatment of Chronic Bronchitis. — Belladonna. — 
Dry spasmodic cough, worse at night and from motion ; tick- 
ling in the throat with constant desire to cough. 

Bryonia. — Dry, hard cough, which seems to come from pit 
of the stomach, and vomiting of food. 

Calcarea carbonicum. — Dry cough at night with cold damp 
feet. 

Causticum. — Short, dry cough, caused by constant tickling 
in the throat, soreness of chest when coughing ; hoarseness, 
particularly in the morning. 

Hepar sulphur. — Rattling, choking cough, worse after 
midnight ; dry hoarse cough, worse in the morning ; cannot 



258 THEORY AND PRACTICE OF MEDICINE. 

bear to be uncovered ; the least exposure to cold excites the 
cough. 

Hyoscyamus. — Dry, spasmodic cough, especially at night, 
and when lying down ; relieved by sitting up. 

Ipecac. — Dry cough, caused by tickling in the upper part 
of the larynx ; (tickling in the chest — phosphorus) ; suffocative 
cough, with rattling of mucus in the bronchial tubes when 
breathing. 

Kali bichromicum. — Loose cough, with rattling in the 
chest, expectoration of a bluish lump of mucus, or tough and 
stringy. 

Lachesis. — The slightest pressure on the larynx causes vio- 
lent cough and a sense of suffocation ; cannot bear any thing 
on the neck. 

Lycopodium. — Expectoration gray and salty ; fan-like mo- 
tion of the alae nasi ; red sediment like sand in the urine. 

Phosphorus. — Dry, tickling cough in the evening, with 
tightness across the chest ; cough often dry and spasmodic. 

Pulsatilla. — Dry cough during the night, going off when 
sitting up in bed ; (worse when sitting up, kali carbonicum, 
zinc). Pulsatilla has also morning cough, with much yellow, 
salty, bitter, disgusting expectoration ; sometimes attended 
with vomiting. 

Spongia. — Larynx dry, with hoarse, hollow, wheezing 
cough, worse in the evening ; sawing respiration ; laryngismus 
stridulus. 

Stannum. — Loose cough, with rattling breathing, with 
profuse greenish expectoration of a disagreeably sweetish or 
putrid taste. 

Sulphur. — Much rattling of mucus in the lungs ; cough 
worse in the morning ; expectoration of greenish lumps, hav- 
ing a sweetish taste. 

Tartar emetic. — Throat full of phlegm, but does not yield 
to coughing; nausea, and vomiting of large quantities of 
mucus ; thirst day and night. 



THEORY AND PRACTICE OF MEDICINE. 259 

Veratrum album. — Deep hollow cough, tickling down in 
the bronchial tubes, with blueness of the face. 

I will now give you a few specific agents. 

Cough worse at night — Acid oxalic, belladonna, mercurius^ 
drosera, hyoscyamus. 

Cough worse in the morning — Rumex, kali bichromicum. 

Cough worse on lying down — Pulsatilla, conium, drosera, 
hyoscyamus, laurocerasus. 

Cough relieved on lying down — Manganum acetate, sepia. 

Capillary Bronchitis. — This is a disease that is con- 
fined to children and the aged. It is an inflammation affect- 
ing the mucous membrane of the lobules of the lungs, and 
hence it is sometimes called lobular pneumonia, in contradis- 
tinction to lobar pneumonia, or inflammation of the lobes of 
the lungs. 

Symptoms. — The child is feverish and fretful, with a 
coiigh ; the fever becomes high, the pulse ranging from 100 
to 150 per minute. The breathing is peculiar; the child 
breathes very rapidly for a few seconds, and then the breath 
almost stops, when it begins its rapid movement again. If 
the child is old enough, it complains of pain in the stomach, 
instead of the lungs. One or both cheeks are flushed. Per- 
cussion yields nearly a resonant sound ; auscultation reveals a 
subcrepitant rale. 

Diagnosis. — Thesubmucusrhoncus, absence of dullness 
on percussion, distinguishes this disease from lobar pneumo- 
nia, while the mucus rhonchus indicates bronchitis of the 
larger tubes. 

Prognosis. — This disease is very fatal during some epi- 
demics. It often, however, yields very readily to homoeo- 
pathic treatment, when not complicated. 

Treatment. — This disease must be treated upon the 
same general principles laid down under the head of bron- 
chitis and pneumonia. 



26o THEORY AND PRACTICE OF MEDICINE. 

For the febrile stage aconite and veratrum viride must be 
chosen in accordance with the symptoms. 

Antimonium tart, in the third potency is almost specific 
in the inflammatory stage to arrest the spread of the disease. 
If, however the inflammation has gone so far as to produce 
mucus rhonchus, without expectoration, then antimonium 
tart., in the 6x to 30X is an invaluable remedy. 

Belladonna is a valuable remedy when the child has flushed 
face, with tickling cough and soreness of the chest, and start- 
ing when dosing. 

Bryonia. — This is an invaluable remedy for hard, deep, 
cough. 

Phosphorus may be called for in certain stages of the 
disease. 

ASTHMA. 

This is a disease that is characterized by spasm of the 
bronchial tubes. 

Symptoms. — The attack comes suddenly, and usually 
at night, generally in the after-part of the night. The patient 
often awakes gasping for breath, and rushes to an open win- 
dow, hoping to find relief. He stands or sits leaning his head 
on his hands. He wheezes loudly, and feels as though he 
could never get another breath. He looks anxious, eyes star- 
ing, sometimes look as though they would protrude from their 
sockets. There is no fever, yet the pulse is rapid, and often 
feeble, owing to the spasm of the bronchial tubes. The face 
turns purple, owing to the exclusion of oxygen from the lungs. 
The whole body becomes cold and purple, and the skin is 
bathed with a cold, clammy sweat. After from one to three 
hours there is a remission, when the patient is able to cough 
up some mucus, and falls into a quiet slumber. The paroxysm 
is liable to return the next night, and pursue the same course, 
unless relieved by treatment. I have known the paroxysm to 
last from twenty-four to thirty hours. 



THEORY AND PRACTICE OF MEDICINE. 26l 

Diagnosis. — Uncomplicated asthma is easy to diagnose, 
as no other disease gives the spasmodic effort at breathing. 
Croup may simulate asthma but the crowing metallic sound 
of croup will distinguish the two. 

Cardiac Asthma. — That is, asthma in a patient who has 
heart trouble — has short breathing after exercise ; but it does 
not have the prolonged expiration, and wheezing like simple 
asthma. An examination of the heart's action will also deter- 
mine the character of the trouble. 

Prognosis. — Is almost always favorable, for a large ma- 
jority of asthmatic patients live to be quite old. Yet if the 
disease is not modified by treatment, or a change of climate, it 
may develop dilatation of the heart or dropsy. 

Causes. — There is no doubt that the asthmatic diathesis 
is hereditary, and hence the disease may be induced by vicis- 
situdes of climate. Powdered ipecacuanha, and odors of vari- 
ous kinds, will often excite bronchial tubes into spasmodic 
action. 

Hay asthma is induced, during the months of July and 
August, by newly-mown hay, and the odor of some flowers. 
This variety of asthma begins with sneezing and coryza before 
the bronchial tubes become involved. 

Treatment of Acute Asthma. — Asthma is curable in 
many cases, but some cases are cured by a change of climate. 

Aconite. — Spasmodic, rough, croaking cough, with con- 
striction of the windpipe. 

Acidum hydrocyanicum. — Gasping for breath ; suffocating 
spells ; he clutches at his heart ; palpitation. 

Cuprum metallicum. — Is indicated for violent attacks of 
nervous asthma. 

Ipecac. — Spasmodic asthma, with violent contraction in 
the throat and chest ; rattling noise in the bronchial tubes 
during an inspiration ; nausea. 

Lobelia inflata. — Has short, anxious, wheezing respiration, 



262 THEORY AND PRACTICE OF MEDICINE. 

with prickly sensation through the whole body, even to the 
ends of the fingers and toes. 

Veratrum viride. — Labored breathing ; must sit up ; cold 
sweat on the face, and nausea. 

Treatment of Chronic Asthma. — Argentum nitri- 
cum has violent attacks of dry spasmodic asthma, forcing him 
to arise and walk about. 

Arsenicum. — Attacks of suffocation, especially at night; 
cannot lie down for fear of suffocation. 

Belladomta. — Attacks come on in the afternoon or even- 
ing ; sensation as if dust were in the lungs, better when hold- 
ing the breath, or bending the head back ; face and eyes red 
and hot ; sleepiness, but cannot sleep. 

Conium. — Asthma in the morning on waking ; face of a 
bluish-red color. 

Mullein. — We have no definite proving of verbascum or 
mullein in asthma, but it is a popular remedy, and many 
cases have been cured by using a tea made from the leaves. 

Nux vomica. — Spasmodic constriction of the larynx after 
midnight ; suffocating spells. Asthma, with fullness in the 
stomach ; better after belching. 

Sambucus. — Nightly suffocative paroxysms, with spas- 
modic constriction of the chest. 

Spongia. — Awakens often in a fright, and feels as if suffo- 
cating ; hoarse, hollow, wheezing cough. 

Veratrum album. — Violent paroxysms of spasmodic asthma, 
with coldness of the nose, ears, and feet, cold perspiration, and 
great prostration. 

Treatment of Cardiac Asthma. — Cactus grandi- 
florus, arsenicum and spigelia, are the remedies indicated for 
this disease. 

Treatment OF Hay Asthma. — Gelsemium and saba- 
dilla are especially indicated for this affection. It is said that 
if hay asthmatic patients will leave their place of abode, and 



THEORY AND PRACTICE OF MEDICINE. 263 

spend July, August, September and October near the lakes in 
Michigan, they can escape an attack of hay asthma one year 
after another. 



CYNANCHE THYROIDEA. 

BRONCHOCELE — GOITRE. 

This is a morbid growth of a part, or the whole, of the 
thyroid gland. It develops slowly at first, but when it reaches 
a certain stage, it progresses rapidly until it attains an enor- 
mous size, often as large as an infant's head. 

Anatomical Characters. — The gland when cut open 

is found to consist of cells, varying in size from that of a pea 
to quite large cavities. These cells are rilled with fluids of 
various character and consistency. Sometimes the enlarged 
gland is more solid and compact. 

Causes. — Predisposing. — Female sex ; males may have 
it in proportion of one to twelve females. 

Exciting. — Not fully known, but some believe that the 
habitual use of limestone water, will cause it to develop in 
the hereditary diathesis. Whether this be true or not, I be- 
lieve that all limestone water should be boiled before using 
for drinking purposes. 

Prognosis. — It is free from danger, unless it is neglected 
until the gland becomes so enlarged and firm as to press upon 
the trachea, and thus cause suffocation. 

Treatment. — Biniodide of mercury should be given 
morning and night for a month. Then give spongia three 
times a day until the gland begins to reduce in size ; then give 
two doses per day, and finally drop down to one dose per day. 
If the tumor is slow about reducing, then you can give iodine 
for awhile. If you think it necessary you can give the binio* 
dide of mercury again for a few weeks. 

Iodine, iodide of mercury, and spongia, are the only reme- 
dies that I have found necessary to cure all of the cases that 
have come under my observation. But whatever symptoms 



264 THEORY AND PRACTICE OF MEDICINE. 

may arise, or the diathesis of the patient, may call for other 
remedies. 

I always use the followiug liniment externally while using 
the internal remedies : tincture iodine, one ounce ; tincture 
belladonna, half ounce ; tincture aconite, half an ounce. Mix 
and apply to tumor morning and night. 

You can promise a cure in from one to two years. If the 
gland is soft, then you may be able to cure in six months ; 
but if very hard it will require a long time. If you do not 
impress the patients that it will require a long time, they will 
take your medicine for a short time, and if they see no im- 
provement they will quit you. If you give the medicines in 
the third potency, then you must discontinue the treatment 
for awhile after the system is well under the influence of the 
remedies, or you must go higher with your potencies. 

PNEUriONITIS. 

PNEUMONIA. 

This is a disease, as its name implies, in which one or 
both lungs may be the seat of inflammation. If both lungs 
are affected it is said to be double pneumonia, and the case is 
much more serious than when only one is diseased. I shall 
now speak of pneumonia in general terms, whether it affects 
one or both lungs ; for the treatment will vary but little. It 
is only in prognosis that double pneumonia requires our spe- 
cial consideration ; for our prognosis must always be much 
more grave in this than in the single or simple variety. 

For convenience of description, pneumonia may be di- 
vided into the following varieties. 

Acute Lobar Pneumonia. 

Acute Lobular Pneumonia or Infantile Pneumonia. 
Chronic Pneumonia. 
Pneumonitis. ■( Bilious Pneumonia. 

Miasmatic Pneumonia. 
Typhoid Pneumonia. 
L Gangrene of the Lungs. 



THEORY AND PRACTICE OF MEDICINE. 265 

Symptoms. — Acute Pneumonia. — This disease be- 
gins with a feeling of indisposition, followed by a cold sensa- 
tion in the back and limbs. This sensation soon gives place 
to a chill, followed by pain and cough. The cough is slight 
and hacking at first. The pain is sometimes sharp, but more 
generally it is dull and aching. The pain is found to be near 
the seat of inflammation, which generally occurs in the lower 
lobes of the lungs, and if the disease is single, the pain is re- 
ferred most generally to the right mammary region. Chil- 
dren complain of pain in the stomach. At the time, or soon 
after these symptoms manifest themselves, a fever is devel- 
oped, which may be asthenic in proportion to the amount of 
local trouble, and aplasticity of the patient. As the disease 
advances, the local and general symptoms keep pace with each 
other. The pulse becomes frequent, ranging from no to 140 
per minute. The temperature rises with the increase of the 
febrile excitement, and when the disease has reached its acme 
the thermometer shows an increase of temperature of 102 ° to 
103 F. If the temperature reaches 104 , the symptoms be- 
come alarming. The cough, which at first was dry and hack- 
ing, becomes more troublesome, and the patient expectorates 
a large amount of mucus mixed with blood. The blood is 
so thoroughly intermixed with the viscid matter, which is 
thrown up, that the expectoration has a rusty color. This 
brick-dust sputa is one of the most characteristic signs of 
pneumonia. As the disease progresses, and hepatization and 
suppuration take place, the rusty sputa gives place to a 
muco-purulent expectoration, which is indicative of the third 
or suppurative stage of pneumonia. The breathing becomes 
laborious, and the respiration is quick from the beginning of 
the congestive stage, and it increases with the progress of the 
inflammatory and hepatized stages. The countenance looks 
dull, the face looks bloated, and of a dark color. The head 
is sometimes painful ; the skin is hot and dry, and delirium 
is often present. The appetite is impaired in the early stages, 
and is finally lost. Thirst is sometimes intense ; the tongue 



266 THEORY AND PRACTICE OF MEDICINE. 

is heavily coated, and may be dry or moist, but more gener- 
ally it is dry. 

By the aid of auscultation and percussion certain valuable 
signs have been developed which are known as physical signs. 
By the phenomena that accompany these signs we are able to 
find the locality, and trace the boundaries of the pathological 
change that is going on in the lungs, and to measure each 
grade in their inflammatory process. By the application of 
the physical signs it has been demonstrated that pneumonia 
has three well marked stages ; viz. : i. Congestive ; 2. In- 
flammatory ; 3. Suppurative. Each of these stages is accom- 
panied with certain phenomena which mark their beginning, 
progress and their termination. 

In order that we may understand the changes that take 
place in the lungs during the progress of these stages, and to 
enable us to appreciate the character of the abnormal sounds, 
we must be familiar with the normal sounds of the chest. If 
we auscultate a healthy chest we will be able to recognize 
three well-defined sounds, which have been called the vesicu- 
lar, bronchial, and tracheal murmur. These combined give 
rise to the term, natural respiratory murmur. 

The sound that is heard over different parts of the chest, 
which contains healthy lung tissue, is called vesicular ; because 
it is produced by the rushing of air into the pulmonary cells 
or vesicles. It denotes that the lobules are permeable to air, 
and are therefore in a healthy condition. The vesicular mur- 
mur has been compared to the sighing of a gentle breeze. 
This murmur may be exaggerated or increased, and give rise 
to a morbid sound, which has been called rale. Rale is a 
French term denoting rhoncus, or a rattling sound. The 
vesicular murmur then may become morbid and give rise to 
the vesicular rale, and this may again be subdivided into the 
crepitant, subcrepitant, and crackling rale. The crepitant rale 
is a creaking noise heard in the congestive stage of pneumo- 
nia. When the cavities of the ultimate bronchial tubes are 
diminished in size by congestion of their tissues, the air forces 



THEORY AND PRACTICE OF MEDICINE. 267 

its way into the agglutinated air-cells, and cause their walls to 
separate and press against their neighbor at each act of inspi- 
ration and thereby produce the crepitation. 

The subcrepitant rale is a coarser sound than the crepi- 
tant. It is heard under similar circumstances and differs only 
in this, that the congestion has progressed so far as to produce 
an exudation of lymph into the tissues of the lobules, and into 
the air-cells which gives a bubbling sound that nearly obscures 
the fine crepitations of the former. As the congestive stage 
of pneumonia progresses, these sounds are lost ; and as the 
second stage supervenes, we have dullness on percussion with 
bronchial respiration. The second stage having completed its 
course, the third, or suppurative, stage is ushered in, and its 
presence is known by the submucus and mucus rale. 

We have then as physical signs in pneumonia. 1. Vesicu- 
lar rale ; 2. Dullness on percussion, with bronchial respira- 
tion ; 3. Submucus, and mucus rhoncus. 

It may be well for us to investigate these stages, and see 
what relation they sustain to each other, and ascertain the 
pathological change that takes place in each. First, then, 
what are we to understand by the congestive stage of pneu- 
monia. The term congestion means to amass, or it is an 
undue fullness of the blood vessels. 

The first step in congestion of the lungs is either an irri- 
tation of the tissues, or a paralysis of the capillaries by which 
the blood fails to be carried from the parts, consequently there 
will be an accumulation of blood in the part. This condition 
is known to be present by the crepitant rale to which I have 
already called your attention. 

The second process in the congestive stage is infiltration of 
serum within the interlobular and intralobular spaces. This 
condition is known to have taken place by the subcrepitant 
rale. This is the beginning of the inflammatory stage of 
pneumonia. After this stage is developed crepitation is en- 
tirely lost, and we have in its stead bronchial respiration, 
which is a diagnostic sign of hepatization of the lung. This 



268 THEORY AND PRACTICE OF MEDICINE. 

hepatization is the result of the coagulation of the infiltrated 
fluids within the tissues and air cells. From its color, this 
coagulation has been called red hepatization. In this stao-e 
we have dullness on percussion. 

There are three diagnostic signs of hepatization, i. Dull- 
ness on percussion; 2. Bronchial respiration; 3. Vocal fre- 
mitus. 

Fremitus — Vibration. — In physical diagnosis, the vi- 
bration communicated to the hand is called fremitis. Vocal 
fremitis is produced by the patient speaking while you are 
using the stethoscope on the chest. Tussive fremitis is pro- 
duced bv coughing. Rhoncal fremitis is produced by bub- 
bling of air through fluids in the lungs. Rubbing fremitis, 
is produced by the collision, and rubbing together of plastic 
matter, exuded upon the pleural surfaces. Pulsatile fremitis 
is produced by pulsation of the lung. 

After red hepatization has lasted for a longer or shorter 
period, the infiltrated product undergoes a change, and the 
organic elements begin to disintegrate and assume a whitish 
appearance. It is then called gray hepatization, and is the 
beginning of the third or suppurative stage of pneumonia. 
The approach to this stage is known by the submucus 
rhoncus ; and as disintegration goes on, the submucus gives 
place to the mucus rhoncus or rale. The sputa, which con- 
sisted of mucus and blood in the early stage of the disease, now 
gives place to an expectoration of muco-purulent matter. 

During the progress of the disease, the general symptoms 
are an index to the pathological changes that are going on 
within the lungs. In the inflammatory stage the full rapid 
pulse ; the dry skin, laborious breathing ; the bloated and 
purple face all speak of the conflict within ; and the quick 
feeble pulse, tell of the drain on the system by the suppura- 
tive process going on in the lung tissue during the third stage. 

Chronic Pneumonia. — I have but little to say on this 
subject, since it is doubted by some authors, whether it ever 



THEORY AND PRACTICE OF MEDICINE. 269 

does exist, except as a concomitant of tubercular abscess, or 
as a prolonged attack of acute pneumonia. 

Bilious Pneumonia. — This is a complication that is very 
common in certain latitudes. So far as the disease in the 
lung is concerned, it proceeds in the same way as the acute, 
only the complication makes the case much more grave. The 
principal difference consists in the complication of the liver. 
This is more or less affected, and gives rise to bilious vomit- 
ings and a jaundiced appearance of the skin and conjunctiva 
membrane. There is, generally, tenderness upon pressure 
over the region of the right hypochondrium, which is an evi- 
dence of hepatic derangement. 

Miasmatic Pneumonia. — Pneumonia is often complica- 
ted with remittent and intermittent fevers in miasmatic dis- 
tricts. In these cases the inflammatory stage may be well de- 
veloped, while the general symptoms indicate a miasmatic 
origin of fever. In all of these complications of pneumo- 
nia the disease is much more serious than in the simple 
variety. 



Typhoid Pneumonia. — Under this head, I propose to 
speak of the typhoid condition following an attack of pneu- 
monia. The term typhoid pneumonia properly belongs to 
those cases in which pneumonia complicates typhoid, and in 
which typhoid fever is primary, and pneumonia is secondary ; 
while in the disease now under consideration the pneumonia 
is primary, and the typhoid condition is secondary. 

This variety of pneumonia occurs in patients who are in 
the aplastic diathesis. The symptoms are the same as those 
in the simple variety. But the patient early shows signs of 
prostration ; the tongue becomes dry and brown, sordes gather 
around the teeth ; there is low muttering delirium during his 
dozing moments, and the bowels are sometimes loose, near the 



2JO THEORY AND PRACTICE OF MEDICINE. 

close of the disease. The respiration is frequent, and the pulse 
is quick and feeble. 

Gangr.ena Pulmoxum — Gangrene of the Lungs. — 

A frequent feeble pulse ; expectoration of dingy-green sputa, 
mixed with blood, and a peculiarly offensive odor ; and death 
from exhaustion. This complication is diagnosed by the dark 
and offensive odor of the sputa. 

Causes. — The predisposing cause of pneumonia is cold. 
This disease prevails more extensively during the spring 
months of cold climates, where those months are damp and 
chilly. But in warm climates the disease is liable to occur 
any time during the winter. 

Diagnosis. — I need not dwell long upon the diagnosis 
of pneumonia. The brick-dust or rusty sputa ; crepitant rale ; 
dullness on percussion ; bronchial breathing ; and submucus 
and mucus rhoncus, are diagnostic when taken in connection 
with the history of the case. 

Prognosis. — The prognosis of simple, uncomplicated 
pneumonia is generally favorable. But when it occurs in the 
aged, and infancy, or in the aplastic diathesis, it is sometimes 
grave. Bilious pneumonia is a very dangerous disease in some 
latitudes. The favorable prognostic symptoms are a diminu- 
tion in the frequency of the pulse ; the breathing becomes 
more regular, and if the patient begins to cough with a free 
expectoration in the third stage, it is favorable, for the in- 
creased frequency of the cough indicates that the expectora- 
tion is easy, and that the increased cough is produced by the 
free expectoration. 

The unfavorable symptoms are an increased frequency and 
feebleness of the pulse ; the respiration is quick and laborious ; 
cough is dry, or there may be a dark offensive expectoration ; 
head thrown back, tongue dry and brown ; muttering delirium 
supervenes, and death closes the scene. 



THEORY AND PRACTICE OF MEDICINE. 27 1 

Treatment. — In the treatment of pneumonia our suc- 
cess will principally depend upon two circumstances. 1. The 
time that we are called to the case ; 2. The adaptation of 
suitable remedies to the stage in which we are called. 

The indications for treatment in pneumonia are : 1. To 
arrest congestion ; 2. To check inflammation, and repair dam- 
age already done to the part ; 3. Promote expectoration, in- 
crease vital affinity of the system, and restore tonicity to the 
organic functions. 

The first and most important question to be asked in the 
treatment of pneumonia is, can we ever arrest and cut short 
the disease in the first or congestive stage ? From experiments 
made on a large number of cases I can answer in the affirma- 
tive. If called while the crepitant rale is yet distinct, we can 
arrest a majority of the uncomplicated cases in the first stage, 
if we do not let the golden opportunity pass. 

Treatment of First Stage of Pneumonia. — Aco- 
nite and veratrum viride are your main remedies in the first 
or congestive stage of pneumonia. While veratrum viride is 
almost specific in this stage, yet you must weigh the symp- 
toms carefully between it and aconite. 

Aconite. — Has high fever, full, bounding pulse, violent 
thirst, and shortness of breath ; piercing and stitching pains 
in the chest, with difficult breathing ; great fear and anxiety 
of mind. 

Veratrum viride. — High fever, with strong quick pulse ; 
nausea and vomiting of a glairy mucus ; sinking, faint feel- 
ing in the pit of the stomach. 

Treatment of Second, or Inflammatory Stage. — 
Aconite and veratrum viride must be continued in this stage 
until fever begins to abate, or new symptoms arise. So long 
as the patient is improving, either under aconite or veratrum 
viride, you must not change your remedy unless you see an 
indication for a change. 



272 THEORY AND PRACTICE OF MEDICINE. 

Belladonna. — Flushed face and throbbing carotids ; vio- 
lent delirium, with a wild look, and desire to escape, strike, 
bite, or quarrel ; starting and jumping during sleep ; moaning. 

Bryonia. — Hard cough, with expectoration of a tenacious 
mucus, of a reddish or rusty color ; great difficulty of breath- 
ing, and acute shooting or stitching pains in the side or chest ; 
wants to lie perfectly quiet. 

Kali carboiiicum. — Double pneumonia; copious infiltra- 
tion ; coarse vesicular murmur, excessive dyspnoea ; hectic 
symptoms ; intermittent pulse ; tenacious mucus. 

Nitrum. — Great dyspnoea, must lie with the head high ; 
cough, with cutting, stitching pains in the chest, and bloody 
expectoration ; pains in the chest when taking a full breath ; 
feeling as if a load were pressing the thorax together. 

Phosphorus. — In violent cases ; tightness across the chest, 
with a dry cough and rust-colored sputa. 

Sanguinaria. — Great difficulty of breathing ; position on 
the back with the head elevated ; stitching, burning pains 
in the chest ; cough, with tough, rust-colored sputa ; circum- 
scribed redness of the cheeks. 

Treatment oe Third or Suppurative Stage. — An- 
timonium tart. — Oppressed breathing ; loose rattling cough, 
but cannot expectorate anything ; impending paralysis of the 
lungs ; inside of the chest feels as if lined with velvet. 

Carbo veg. — Sensation of great weakness and fatigue in 
the chest; cough by spells, with brownish expectoration; 
pulse extremely weak ; craves cold air, and wants to be fanned 
all the time ; secretions offensive. 

Lycopoalium. — Copious expectoration mixed with pus ; fan- 
like motion of the alae-nasi ; great fear of being left alone ; 
red, sand-like sediment in the urine. 

Sulphur. — Much rattling of phlegm in the chest ; cough 
on deep inspiration, with cutting pain in left chest ; feels suf- 
focated, wants doors and windows open ; constant heat on top 
of head. 



THEORY AND PRACTICE OF MEDICINE. 273 

Treatment of Chronic Pneumonia. — This form of 
the disease must be treated upon the general plan as that 
given in the suppurative stage of the acute variety. As 
chronic pneumonia has a tendency to merge into quick con- 
sumption, phosphorus and sulphur are your most reliable 
agents. 

Bilious Pneumonia. — When the liver is involved in 
pneumonia, then, in addition to the remedies for pneumonia 
proper, we must resort either to chelidonium majus, mercu- 
rius, or podophyllum. Antimonium tart, is also valuable where 
the cough is rattling and the expectoration tinged with bile. 

Miasmatic Pneumonia. — This complication requires ar- 
senicum, china, and other remedies indicated in remittent fever. 

Treatment of Typhoid Pneumonia. — Arsenicum, 
baptisia, rhus tox., and veratrum viride are indicated in the 
typhoid condition of pneumonia. 

Treatment of Gangrene of the Lungs. — Arseni- 
cum, baptisia, carbo veg. and lachesis, are your main reliance 
in gangrene of the lungs. The patient must be stimulated 
with beef extracts, strong coffee, and nourished with milk, 
and malted milk. 

PLEURITIS or PLEURISY. 

This is a disease which is characterized by an inflamma- 
tory condition of the pleura. You will remember that the 
pleura is a serous membrane enclosing the lungs and lines 
the thorax. It has a smooth lubricated surface which per- 
mits free motion of the viscera within the chest. 

Symptoms. — The patient is often seized with a violent 
chill followed by fever, and severe pain. Usually but one side 
is affected, and the pain is felt below the nipple. There is a 

iS 



274 THEORY AND PRACTICE OF MEDICINE. 

short dry cough at first, followed by difficulty of breathing. 
Sometimes the patient has to sit erect. The pulse is quick, 
hard, and wiry ; tongue is dry and face is flushed. When 
the lung becomes involved the expectoration is very copious 
and streaked with blood. That condition is called pleuro- 
pneumonia. 

If the inflammation is soon arrested, then the pleura returns 
to its normal condition. But if allowed to continue long, an 
effusion is thrown out, and binds the lungs and pleura to the 
sides of the thorax with adhesive bands, and thus impedes 
respiration. Sometimes there is a dropsical effusion takes 
place and produces hydrothorax. Sometimes there is suppu- 
ration, and the whole pleuritic cavity is filled, thus producing 
empyema. I remember once assisting in aspirating the chest 
for pleuritic effusion, and we took out 214 ounces of pus and 
a straw-colored fluid, and the patient recovered. 

Physical Signs. — In the early stage of inflammation of 
the pleura the stethoscope reveals a friction sound over the seat 
of the disease, owing to the dry condition of the membrane. 
The inflamed surfaces produce a rubbing sound which may be 
felt by placing the hand flat over the inflamed membrane. 
The friction sound is soon lost by an exudation of fibrin, and 
then we get dullness on percussion. 

In the early stage the patient rests on the sound side ; but 
after effusion takes place, known by dullness on percussion, 
he turns on the affected side so that the dropsical pleura may 
not impede the movement of the healthy lung. 

Pathology. — You may readily infer from the symptoms 
what the pathological conditions are, after a prolonged attack 
of pleurisy. 

Causes. — Exposure to vicissitudes of climate ; surgical 
operations, and injuries of the chest, may induce the disease. 

Diagnosis. — The friction sound, and sharp pain, with 
difficulty of breathing, and desire to rest on the sound side, 
are diagnostic symptoms of pleurisy. The absence of the 
crepitant rale, and rusty sputa, distinguish it from pneumonia. 



THEORY AND PRACTICE OF MEDICINE. 275 

The sharp piercing pain on breathing or moving, in the 
region of the intercostal muscles, point to pleurodynia, instead 
of pleurisy. 

Prognosis. — Is generally favorable, unless the disease 
becomes chronic and complicates other diseases. 

Treatment OF Pleurisy. — In acute pleurisy, aconite 
and bryonia are your main remedies. Aconite for a full 
bounding pulse, dry, hot skin, agonized tossing about, violent 
thirst for large draughts of water, red face, shortness of 
breath, and great nervous excitability ; piercing and stitching 
pains in the chest, hindering respiration, with dry cough ; in- 
ability to lie on the right side. 

Bryo7iia. — Is our grand remedy for inflammation of all 
serous membranes. It is indicated in pleurisy for stinging, 
shooting, or burning pains in the side, aggravated by breath- 
ing or movement ; painful dry cough, or cough with expec- 
toration of glairy sputa ; labored, short, anxious, and rapid 
respiration, performed almost entirely by the abdominal 
muscles. 

Arnica. — Is indicated after injuries to the chest. Stitch- 
ing pains in the left side of the chest, with a short, dry cough ; 
constantly changing about on account of the bed feeling so 
hard. 

Arsenicum. — This remedy is especially called for after ef- 
fusion within the pleural cavity, producing hydrothorax, or 
dropsy of the chest. There is oppressed breathing, with suf- 
focation ; coldness of the body, with prostration. Apis and 
apocynum are also indicated in hydrothorax. 

Kali carbonicum. — Is indicated for cutting pains in the 
right side. {Arnica, phosphorus, squilla, for left side). 

Iodine. — This is a valuable remedy in scrofulous patients, 
when effusion has occurred. 

Phosphorus. — Is indicated for pleuro-pneumonia, especially 
in the chronic form, where there is danger of consumption 
being developed. 



276 THEORY AND PRACTICE OF MEDICINE. 

Rhus tox. — If pleurisy is induced by rheumatism, or ex- 
posure, or sprain, then rhus tox. is the indicated remedy. 

Senega. — Is indicated for pleural effusion subacute or 
chronic. 

The diet should be light and nourishing. The patient 
should be kept quiet. If the chest seems to be filling in spite 
of your remedies, then you should aspirate as soon as the 
pressure begins to impede the breathing and the heart's 
action. 

PERTUSSIS. 

HOOPING-COUGH (WHOOPING-COUGH.) 

This is a contagious disease affecting the mucous mem- 
brane of the bronchi. It is characterized by a peculiar spas- 
modic cough called the hoop, whoop, or kink. 

Causes. — The cause is not well understood ; but it is 
evident that a ferment, or bacilli, is conveyed through the air 
and families. All that is necessary for the unprotected to 
take the disease, is to inhale the breath or air from the sick 
room. 

Symptoms. — The disease is ushered in with all of the 
premonitory symptoms of bronchitis or a common cold. The 
child becomes feverish, and after a week or ten days the cough 
becomes spasmodic. A tickling in the larynx reminds the 
child of the advent of a paroxysm, and it lays hold of some- 
thing during the fit of coughing. The child coughs in 
kinks, and turns red in the face. Soon after this period it 
begins to hoop, and often turns purple in the face. Blood 
sometimes gushes from the nose and mouth. The paroxysms 
occur from one to three hours during the day, the child is dis- 
turbed from sleep during the night. 

Diagnosis. — It is difficult to distinguish the early stages 
of hooping-cough from ordinary colds. But in hooping-cough 
the child has regular paroxysms, and turns red in the face. 
When the hoop occurs then all doubt is removed. In hoop- 



THEORY AND PRACTICE OE MEDICINE. 277 

ing-cough the hoop follows the cough ; in spasmodic croup, 
it precedes it. 

Treatment. — As a rule drosera is often the only remedy 
needed in simple uncomplicated hooping-cough. The symp- 
toms, however, should be watched closely, and select the indi- 
cated remedy in accordance with the symptoms. 

Aconite. — The child is feverish and grasps at its throat 
with every cough. 

Anacardium. — Children with uncontrollable temper. 

Arsenicum. — Great prostration with waxy paleness and 
coldness of the skin. 

Ammonium bromatum. — Drs. Harley and Gibbs report 
this remedy as almost specific. 

Belladonna. — The child gets very red in the face with 
every coughing spell ; nose bleeds. 

Corallium rubrum.— Cough so violent that the child loses 
its breath, and turns purple and black in face. 

Cuprum. — During the attack, the child becomes rigid, 
turns black in the face, and seems as if dead ; vomiting after 
the paroxysm. 

Drosera. — Violent spasmodic cough, threatening suffoca- 
tion, worse after midnight ; vomiting of food and mucus. 

Hepar sulphur. — Cough sounds croupy ; coughs when any 
part of the body is exposed ; rattling, choking cough. 

Ipecac. — The chest seems full of phlegm, but cannot get 
it up. Nausea and vomiting. 

Kali bichromicum. — Choking cough with expectoration of 
viscid mucus. Burning pain in the trachea and bronchi. 

Mercurius. — Cough only at night, or early during the day.. 
Two paroxysms succeed each other closely, and are separated 
from the next two by an interval of perfect rest. 

Squilla.— Constant rubbing of the nose, face, and eyes, 
during the cough. Cough excited by cold drinks, and from 
exertion. 

Tartar emetic, — Rattling cough, but nothing is expector- 
ated. Nausea and vomiting of large quantities of mucus. 



278 



THEORY AND PRACTICE OF MEDICINE. 



Veratrum album. — After every coughing spell, the child 
falls over exhausted, with cold sweat upon the forehead ; 
vomiting of tough, thin mucus, and involuntary discharge of 
urine ; worse entering a warm room. 

The diet should be nourishing and of easy digestion. 



CIRCULATORY SYSTEM. 



HEART. 



Functional. 



Organic. 



Palpitation, 

Syncope, 

Neuralgia of the Heart. 

Angina Pectoris, 

Pericarditis, 

Endocarditis, 

Valvular Complication, 

Carditis, 

Hypertrophy, 

Dilatation, 

Cyanosis. 



arteries Aneurism, 



VEINS 



Phlebitis, 
Varicose Veins, 
Phlegmasia Dolens. 



blood, morbid condition . . Purpura and Anaemia. 



PALPITATION. 

Palpitation of the heart is a tumultuous, irregular or inter- 
mittent action of that organ. The least exercise, mental or 
physical, brings on an attack. The patient complains of a 
weak or smothered sensation ; the heart beats so rapidly as to 
be observed by the bystander. 

Causes. — Predisposing. — The nervous temperament ; 
the female sex ; debility. 

Exciting. — Grief, fear, anxiety, sadness, mental emotions, 
joy ; violent exercise, or any thing that debilitates the patient ; 



THEORY AND PRACTICE OF MEDICINE. 279 

abuse of purgatives, unwholesome diet ; the abuse of spiritu- 
ous, vinous, or fermented liquors ; chewing and smoking to- 
bacco. 

Diagnosis. — The history of the case, general anaemic 
condition of the patient, intermittent character of the parox- 
ysm all point to palpitation, or functional rather than organic 
disease of the heart. In organic diseases of the heart palpi- 
tation comes on slowly. While in functional derangement 
it is sudden in its development, and may be traced to indiges- 
tion, mental or nervous excitement. 

Treatment. — Primarily you must give something to 
quiet the heart's action, and secondarily search for and re- 
move the cause. If indigestion is the cause, then the reme- 
dies suggested for dyspepsia must be resorted to. If nervous 
excitement, hysteria, etc., is the cause gelsemium or moschus 
will be sufficient. If fear and anxiety is the cause then aconite 
is your remedy. 

Intermittent Pulse. — When the heart's action loses a 
beat it is called an intermittent pulse. Sometimes the pulse 
intermits every other, or every third or fifth beat. 

Causes. — It is generally supposed to be due to deficient 
nerve force. Dr. B. W. Richardson, of London, in speaking 
of intermittent pulse says : "'I have never met with a case in 
which it has not been traceable to some form of cerebral ex- 
citement, with succeeding depression. Grief from the death 
of friends, shock from failures of business, disappointments, 
violent outbursts of passion, remorse, degradation ; and, most 
fruitful cause of all in this madly striving age, overwork of 
brain ; these are the outside influences leading to the changes 
on which the phenomenon of intermittency of the pulse most 
frequently depends. 

Treatment. — Belladonna, digitalis, gelsemium, mos- 
chus, and spigelia are your principal remedies. Avoidance of 
all excitement, rest quiet, and sleep, are essential elements 
for intermittency of the pulse. 



<2'8b THEORY AND PRACTICE OF MEDICINE. 

SYNCOPE. 

FAINTING. 

A person about to faint feels a little dizzy, the eyes be- 
come dim, and without support he falls unconscious to the 
floor. The patient for the time being is unconscious ; the 
lips are pale, and the pulse is feeble, or fluttering. 

Causes. — Debility from whatever produced. Some per- 
sons are constitutionally predisposed to fainting spells. Often 
the sight of blood causes swooning in some. 

Diagnosis. — Simple syncope lasts only a few seconds ; 
while hysterical swooning may last for hours, and yet the 
pulse is nearly normal. 

Treatment. — The patient must be placed in the hori- 
zontal position, and sometimes the head must be lower than 
the body. 

Moschus or camphor by olfaction until the patient rallies, 
then give nux moschata until the patient is fully restored. If 
caused by fright, aconite and opium are valuable remedies. 
To overcome the tendency to syncope, arsenicum, china, 
and iodine are the remedies mostly indicated. Nux moschata 
is indicated when patients awake early with a dry mouth. 



NEURALGIA OF THE HEART. 

Symptoms. — This disease differs from angina pectoris 
in consisting of a darting pain in the region of the heart, 
without any affection of the respiration ; and, in most cases, 
without any alteration in the heart's beat. It is purely 
nervous. 

Diagnosis. — From organic diseases of the heart, by the 
absence of the stethoscopic signs of those diseases. From 
angina pectoris, by the little disturbance of the circulation, 
by the pain not being accompanied by the peculiar suffering 
of angina, and by the absence of the pains in the arms. 



THEORY AND PRACTICE OF MEDICINE. 28 1 

Treatment. — Aconite is called for when there are 
stitches at the heart with hard full pulse. 

Cactus grandiflorus. — Pricking pains impeding breath- 
ing ; dull heavy pain, worse from pressure. 

Spigelia. — Stitches about the heart ; palpitation, violent ; 
worse from bending forward. 

ORGANIC DISEASES OF THE HEART. 

ANGINA PECTORIS BREAST PANG. 

Symptoms. — Violent pain in the region of the heart, 
which extends to the shoulder and left arm. There is diffi- 
cult breathing ; the patient is compelled to stand still when- 
ever he is attacked ; it only lasts for a few minutes. After 
continued attacks, it sometimes proves fatal. 

Causes. — Predisposing. — The male sex; advanced 
age, but may occur as early as thirty-five years. The excit- 
ing causes are mental and physical excitement. 

Proximate. — Organic diseases of the heart and large ves- 
sels ; viz., ossification of the coronary arteries ; ossification of 
the valves of the heart ; morbid accumulation of fat ; soften- 
ing of the muscular structure of the heart. 

Treatment. — Aconite. — Heart beats quick and strong, 
with great sense of suffocation. 

Arsenicum. — Sudden tightness above the heart ; agonizing 
precordial pain ; pains in the neck and occiput ; breathing 
difficult, fainting spells ; least motion makes him lose his 
breath. 

Cactus grandiflorus. — Pains in the apex of the heart, shoot- 
ing down the left arm to the ends of the fingers ; pulse feeble ; 
dyspnoea. 

Cuprum aceticum. — Cases have been reported cured by this 
remedy. 

Veratrum album. — Slow, intermittent pulse, cold extremi- 
ties, cold perspirations. 



282 THEORY AND PRACTICE OF MEDICINE. 

PERICARDITIS. 

INFLAMMATION OF THE PERICARDIUM. 

The pericardium is a fibre-serous membrane which invests 
the heart. It is rare that idiopathic pericarditis occurs, but 
it is of frequent occurrence in rheumatic patients. 

Symptoms. — There are rigors followed by fever, and 
pain in the left side of the chest, and is more acute under the 
left nipple, shooting up to the left shoulder, and down the left 
arm. There is frequent palpitation with dyspnoea. 

Physical Signs. — Before exudation has taken place, aus- 
cultation detects over the region of the heart a double fric- 
tional sound, called to-and-fro-sound, and resembles the sound 
heard by rubbing your hands back and forth. When the 
secretion becomes thicker, then there is a rasping sound heard. 
There is often a bellows, or blowing sound, heard when the 
sack is well filled. 

Diagnosis. — This is sometimes most difficult ; the rasp- 
ing sound, and the bellows or blowing sound, distinguish peri- 
carditis from pneumonia and pleuritis. If there is dullness 
on percussion in front while the posterior chest is resonant, 
then we infer that the infiltration is in the pericardium. But 
if there is dullness both front and back then the supposition 
is that the infiltration is pleuritic. There is usually a fullness 
or projection of the region of the left breast when the peri- 
cardium is involved. 

Causes. — Predisposing. — The rheumatic diathesis. 

Exciting. — Cold, and vicissitude of climate. 

Prognosis. — The disease may terminate in recovery ; 
in chronic pericarditis ; but generally in death. 

Treatment. — Aconite. — A double friction-sound in 
rheumatic cases. 

Arsenicum. — Palpitation of heart, with anguish, cannot 
lie on back ; increased by going up stairs. Hydropericardium 
with great irritability, anguish and restlessness. 



THEORY AND PRACTICE OF MEDICINE. 283 

Bryonia. — Rheumatic cases ; oppression in the region of 
the heart*; stitching pain in the region of the heart. 

Cactus grandiflorus. — Sensation of constriction in the 
heart, as if an iron hand prevented its normal movements ; 
Dull heavy pain, worse from pressure ; suffocating respiration ; 
face blue ; edema, especially of the left hand and of the legs 
to the knees ; feet icy cold ; pulse intermittent. 

Colchicum autuntnale. — Heart disease following rheuma- 
tism ; hydropericardium. 

Spigelia. — Stitches about heart ; palpitation, violent, worse 
bending forward. 

ENDOCARDITIS, 

INFLAMMATION OF ENDOCARDIUM. 

This is an inflammation of the endocardium, which is a 
fibro-serous membrane lining the interior of the heart. Most 
all of the symptoms mentioned in primary pericarditis are 
also applicable to endocarditis. 

Diagnosis. — The friction-sounds of pericarditis are con- 
fined to the region of the heart ; the valve-murmurs of endo- 
carditis are heard beyond that region. Both the aortic and 
mitral valves are generally affected. The mitral complica- 
tion is more generally fatal. A" systolic mitral murmur heard 
extending an inch and a half beyond the nipple is most proba- 
bly due to mitral regurgitation. If an aortic murmur exist, 
it can only be distinguished in the neck, just above the ster- 
num, over the innominate artery. If, after listening to the 
first sound, the second sound be observed to follow clearly and 
distinctly, there is probably no affection of the aortic valves, 
even if there be a loud systolic murmur. If, however, the 
second sound be indistinct, inaudible, or prolonged, or be re- 
placed by a diastolic murmur, acute endocarditis may be sus- 
pected or detected. 

Prognosis. — Endocarditis is rarely fatal; but when 
the valves become involved, it eventually proves fatal. 



284 THEORY AND PRACTICE OF MEDICINE. 

Treatment. — The same treatment as recommended for 
pericarditis is applicable to endocarditis, and hence I need 
not consume your time repeating the remedies here. 

VALVULAR DISEASES OF THE HEART. 

Symptoms. — The general symptoms belonging to val- 
vular complications are so similar to the diseases of the heart 
proper, that it is almost impossible to make the distinction. 
It is only by physical signs that we are able to be positive as 
to the character of the trouble. The sounds usually heard 
by applying the stethoscope over the region of the heart, are 
the bellows sound, saw sound, and rasp sound. 

Semilunar Valves. — The sounds produced by disease of 
the semilunar valves of the aorta, are distinctly heard, not 
only over the site of the valves themselves, but also in the 
course of the artery, while they diminish in intensity from 
the base to the apex of the heart, where they become inaudi- 
ble. On the other hand, the sounds produced by diseases of 
the auriculo-ventricular valves are heard most distinctly about 
an inch above the apex of the heart, and become less distinct 
in the track of the large vessels. The sounds have a louder 
and sharper tone in disease of the aortic, than in that of the 
auricular valves. In each valve there are two causes of ab- 
normal sound — the direct flow of blood, and the regurgitation ; 
the first is synchronous with the systole of the ventricles and 
with the pulse ; the second, with the diastole of the ventricles. 

Aortic Valves. — Murmur loudest at the middle of the 
sternum, but distinct in the course of the large arteries ; ac- 
companying the pulse, if it depends upon the onward current, 
but following it if caused by regurgitation ; the sound super- 
ficial, and of a peculiar whizzing character ; the pulse thrill- 
ing, but often full and regular. There is sometimes a double 
sound, in which case the diseased valves offer an impediment 
to the entrance of blood into the artery, while their imperfect 
closure permits of reflux. The first sound, therefore, accom- 



THEORY AND PRACTICE OF MEDICINE. 285 

panies the systole, and the second the diastole of the left 
ventricle. 

Mitral Valves. — Murmur loudest opposite the left mar- 
gin of the sternum, between the third and fourth ribs ; more 
hollow and distinct in its character, generally accompanied by 
distinct purring tremor ; the sound, either single or double, 
synchronous either with the first or second sounds of the heart, 
or with both. The first sound is caused by regurgitation from 
the ventricle into the auricle, and is accompanied by a feeble 
and irregular pulse ; the second caused by an impediment to 
the passage of blood from the auricle to the ventricle. The 
sound produced by regurgitation, and accompanying the systole 
of the ventricle, is the one most commonly heard. 

Diagnosis, — The diagnosis of the diseases of the valves 
of the heart may be greatlv assisted by bearing in mind the 
following facts ; 1. These diseases are much more frequent on 
the left than on the right side of the heart ; 2. When they 
occur on the right side, the left is generally affected at the 
same time ; 3. Diseases of the right side are marked by the 
venous pulse, and but little change in the arterial circulation, 
the pulse being only so far affected as the circulation is re- 
tarded; 4. Diseases of the left side have less effect on the 
venous circulation, and do not occasion the venous pulse, but 
they have a marked effect on the arterial circulation ; 5. 
Sounds, whether on the right or left side, which accompany 
or take the place of the first sound of the heart, or the systole 
of the ventricles, and are synchronous with the pulse, are due 
to the passage of the blood out of a ventricle ; that is to say, 
to regurgitation into the corresponding artery ; 6. Sounds, 
whether on the right or left side, which accompany or take 
the place of the second sound of the heart, or the diastole of 
the ventricle, and are not synchronous with the pulse, are due 
to the entrance of blood into the ventricles, in consequence of 
the contraction of the corresponding auricles or regurgitation 
from the corresponding arteries ; 7. Sounds which are heard 
at the base of the heart, and in the course of the aorta toward 



286 THEORY AND PRACTICE OF MEDICINE. 

the right clavicle, becoming less audible towards the apex of 
the heart, indicate disease of the valves or coats of the aorta, 
If the sound accompanies the contraction of the ventricle, 
and is synchronous with a regular, equal, thrilling pulse, it is 
due to disease of the valves or coats of the aorta ; but if the 
sound accompanies the diastole of the ventricle, is not syn- 
chronous with the pulse, the pulse, at the same time, being 
abrupt and jerking, and the abrupt second sound of the 
heart being absent or vers' obscure, the sound is due to reflux 
through the open valves of the aorta; 8. If, on the other 
hand, the sound is synchronous with the systole of the ven- 
tricle and with the pulse, the pulse, at the same time, being 
unequal and irregular, the sound is due to the reflux of the 
blood from the left ventricle, through a diseased mitral valve, 
into the left auricle ; but if the sound is not synchronous with 
the contraction of the ventricle, it is due to the passage of 
the blood from the auricle to the ventricle, through a diseased 
mitral valve. 

Treatment, — The treatment of valvular diseases of 
the heart must be upon the same general principles as recom- 
mended in diseases of the heart. As diseases of the valves of 
the heart are due, in a great measure, to metastasis of muscu- 
lar rheumatism, then the best time to treat those affections is 
when you are treating rheumatism. You should examine the 
heart's action every day so as to be able to detect valvular 
disease in its incipiency, for then is the time to cure it if ever. 
Or you should administer the appropriate remedies for rheu- 
matism of the chest, and thus prevent valvular complications. 
I will call your attention to a few of the most appropriate 
remedies for valvular diseases. 

Cactus. — This is our main stay in valvular diseases of the 
heart. 

Chloral hydrate. — For valvular diseases, with enlargement 
of the abdomen and lower extremities and dropsical tendency ; 
labored breathing. 



THEORY AND PRACTICE OF MEDICINE. 287 

Naja. — This remedy is recommended by some for valvular 
diseases. 

Spigelium. — Is a valuable heart remedy. 

Colchicum.. — This is a remedy that is called for in rheuma- 
tism of the heart. 

CARDITIS. 

INFLAMMATION OF THE HEART. 

Inflammatiou of the substance of the heart is of rare oc- 
currence ; but it may become involved by extension of peri- 
carditis and endocarditis. The treatment must be the same as 
that recommended for pericarditis and endocarditis. 

HYPERTROPHY. 

ENLARGEMENT OF THE HEART. 

Species. — i. Simple hypertrophy ; 2. Hypertrophy with 
dilatation (eccentric) ; 3. Hypertrophy with contraction (con- 
centric). 

Symptoms. — Palpitation ; a strong, regular, and fre- 
quent pulse, small in hypertrophy with contraction, full in 
hypertrophy with dilatation ; slight dyspnoea, increased on 
exertion ; small and feeble pulse ; slight attacks of bronchitis 
and asthma ; bulging of the left breast. 

Causes. — Excessive effort of the heart to overcome ob- 
struction to its action ; valvular insufficiency, diminution of 
nerve force. 

Definition. — Simple hypertrophy is the thickening of 
the walls without change in the capacity of the cavities. 
Eccentric hypertrophy is the thickening of the walls, with 
dilatation of the cavities. Concentric hypertrophy is a thick- 
ening of the walls, with diminution of the cavities. 

Physical Signs. — Impulse of the heart greatly increased 
in force, prolonged and extending over a larger space, visible 
to the eye, and strongly raising the hand of the observer ; the 



288 THEORY AND PRACTICE OF MEDICINE. 

first sound of the heart obscure, when there is little or no 
dilatation ; louder, more abrupt, and heard over a larger space 
where dilatation is at the same time present ; the second sound 
obscure in the former case, unusually distinct in the latter. 
When the palpitations are most violent, there is the bellows 
sound, but it disappears with repose. On percussion, there is 
dullness, varying with the degree of enlargement, and most 
extensive where dilatation is combined with hypertrophy. In 
some instances there is prominence and increased breadth of 
the left side of the chest. 

Prognosis. — The disease may continue for many years ; 
and generally proves fatal in consequence of some secondary 
affection. 

Treatment. — Aconite. — Acute palpitation; great dis- 
tress. 

Apis. — First appearance of dropsy. 

Arsenicum. — Dilatation of the right heart; tendency to 
dropsy. 

Bromine. — This remedy acts beneficially for violent palpi- 
tation of the heart ; cannot lie on the left side ; cutting pains 
running upwards. 

Cactus. — Hypertrophy, with valvular disease ; dropsy. 

Digitalis. — Strong beatings of the heart, with constrictive 
pains under the sternum ; sense of oppression ; intermittent 
pulse. 

Plumbum acetate. — Stitches during inspiration ; anguish 
of the heart ; palpitation ; rush of blood to the heart during 
a rapid walk. 

Spigelia. — Violent palpitation from least motion ; systolic 
blowing at the apex. Rest should be enjoined, both mental 
and physical. 

ATROPHY OF THE HEART. 

Symptoms. — The heart's beat is small and feeble, 
scarcely felt when the hand is placed over the region of the 
heart. If there is atrophy without dilatation, the pulse is 



THEORY AND PRACTICE OF MEDICINE. 289 

very compressible and small. It is full in atrophy with, 
dilatation. 

Causes. — The deposit of fat ; effusion of fluids ; tumors, 
or anything that causes contraction of the muscular fibers 
may produce atrophy. 

Treatment. — The treatment of this complication is 
the same as that given in hypertrophy. 



DILATATION OF THE HEART. 

Dilatation with hypertrophy is said to be active. Dilata- 
tion with thinness of the parieties is passive. The symptoms 
of dilatation with hypertrophy are the same as given under 
hypertrophy. 

Symptoms of Dilatation with Thinness of the 
Parietes. — This usually occurs on the right side. A flut- 
tering of the heart ; a full, frequent, weak, and irregular 
pulse ; swelling of the veins of the neck ; distinct venous 
pulse ; great dyspnoea ; a dusky skin ; a bloated and anxious 
countenance ; drowsiness ; slight delirium ; dropsical effusion. 

Physical Signs. — Feeble impulse, felt, however, over a 
greater extent than usual ; first sound shorter and peculiarly 
distinct, heard over a greater extent of the chest, both before 
and back ; dilatation with hypertrophy, strong impulse, with 
clear sound. 

Causes. — Obstruction to the pulmonary circulation, pul- 
monary emphysema, long-standing diseases of the lungs ; val- 
vular diseases of the left side of the heart. 

Prognosis. — Unfavorable, but in the absence of severe 
complications, of dropsical effusions, or of great debility, the 
patient may survive for a considerable period. 

Treatment. — Cactus and arsenicum are your main 
remedies. 

19 



29O THEORY AND PRACTICE OF MEDICINE. 

CYANOSIS. 

BEUE DISEASE. 

Symptoms. — The whole of the cutaneous surface of a 
blue color, especially the lips. The least exertion causes pal- 
pitation and extreme dyspnoea; the pulse is feeble and irreg- 
ular ; syncope is of frequent occurrence. 

Causes and Anatomical Characters. — Malformation 
of the heart, and hence the admixture of venous and arterial 
blood causes the blueness of the skin. 

Physical Signs. — A very loud and superficial murmur 
immediately over the seat of the communication. 

Prognosis. — Death during a paroxvsm at an early age ; 
in rare instances the patient attains the adult age ; and in 
one case recorded by Louis, the age of fifty-seven. 

Treatment. — The treatment can only be palliative. 
Arsenicum, cuprum, digitalis, lachesis, laurocerasus, and ver- 
atrum album, are your best agents. 

ANEURYSMA. 

ANEURISM. 

Aneurism is due to a dilatation of the coats of the arteries. 
They are of two varieties, idiopathic, and traumatic. The 
former is the result of a diseased condition of the system ; 
the latter is due to wounds, bruises, etc. 

Diagnosis. — This is often difficult. The pain in the 
region of the artery is lancinating and intermittent. If the 
tumor can be felt, then its characteristic is diagnosed by its 
pulsations 

Treatment. — If the tumor is external, compression 
gives the best hopes for recovery ; or the artery may be liga- 
ted, and thus cut off the circulation through the tumor. Dr. 
Tod Helmuth recommends the subcutaneous injection of from 
three to ten drops of a watery extract of secale, and reports 
good results. 



THEORY AND PRACTICE OF MEDICINE. 291 

Aconite, arnica, iodide of potash, phosphorus, and veratrum 
viride have been recommended. 



PHLEBITIS. 

INFLAMMATION OF THE VEINS. 

The tissues of the veins may be so affected as to cause 
embolia, or the obstruction of the vein or artery by a clot of 
blood. 

Symptoms. — The vein becomes tender, hard, and pain- 
ful ; the surface looks red or purple ; rigors followed by fever, 
mouth dry and brown, muttering delirium, vomiting of bile, 
with great prostration. 

Prognosis. — Simple or adhesive phlebitis is not usu- 
ally dangerous ; but the suppurative variety often proves 
fatal from pyaemia ; that, is blood-poison from absorption of 
pus. 

Aconite, belladonna, lachesis and Pulsatilla, are indicated 
for acute adhesive phlebitis. The suppurative variety re- 
quires arsenicum, car bo veg., hyoscyamus, hepar sulphur, mer- 
curius, silicia, and sulphur. Typhoid symptoms, or condi- 
tion, must be treated by the same method as I have laid down 
in the treatment of typhoid condition, occurring in other dis- 
eases. 

Hamamelis is a valuable remedy to put veins in a nor- 
mal condition. 

PHLEGMASIA DOLENS. 

Phlegmasia dolens is peculiar to nursing women, and is 
known as milk-leg, or white-leg. It is an inflammation of 
the veins, and requires the same treatment as phlebitis. I 
have found cloths saturated with a solution of hamamelis, half 
an ounce of the tincture to a quart of water, and applied to 
the limb, to greatly assist the internal remedies in perform- 
ing a cure. 



292 THEORY AND PRACTICE OF MEDICINE. 

VARICES. 

VARICOSE VEINS. 

This is a dilatation of the veins, and occurs mostly in the 
lower extremities. If it affects the veins of the spermatic 
cord, it is called varicocele. 

Symptoms. — The veins dilate and become knotted; 
the tissues have a purpHsh color. The limb is often edema- 
tous. If the limb is elevated and kept at rest the veins and 
swelling diminish. 

Causes. — Over exertion, any thing which prevents the 
return of venous blood, such as tight garters, and certain con- 
ditions of the blood which cause a change in the coats of the 
veins. 

Treatment. — I usually apply a compress saturated with 
a solution of hamamelis for a few days, and then apply rubber 
bandage. If the varicose veins are below the knee then the 
bandage must be applied from the toes to the knee ; but if the 
veins are affected above the knee, then the bandage must ex- 
tend to the hip. It must be applied snugly so as not to press 
too tightly nor loose enough to slip down. It may be worn 
all day and taken off at night, after the patient is in bed and 
replaced in the morning. The limb should never hang down 
until the bandage is replaced. The philosophy is this, the 
rubber keeps a constant pressure which forces the veins to 
contract and at last be reduced to their normal size ; but if 
the bandage is left off then the veins swell again. In order 
to perform a cure, which can be done in six to eighteen 
months, the veins should never be allowed to enlarge after 
they have been once compressed. Some surgeons recommend 
ligation of the veins and thus stop their circulation. In my 
experience the bandage gives the safest and most favorable 
results. 

Hamamelis internally is one of our best remedies. 

Acidum jluoricum, agaricus, Pulsatilla and silicea, are rem- 
edies that are often indicated. 



THEORY AND PRACTICE OF MEDICINE. 293 

VARICOSE ULCERS. 

These are sores of various sizes developed on varicosed 
limbs. Sometimes there is but one large ulcer on one of the 
lower limbs, but frequently there are two on each. They often 
become painful, dark and angry, the limb is swollen, and red 
or purple. The limb may be edematous and pale. 

Treatment. — Many persons suffer long with varicose 
ulcers from the fact that the opinion, among the laity and 
some of the profession, is that it is dangerous to heal ulcers on 
the lower limbs. I am happy to say that after a long experi- 
ence, and having cured many and all cases that have come 
under my treatment, I have never known a single death or 
impairment of health. 

If the limb is inflamed and the ulcers sensitive, I apply a 
compress saturated with a solution of hamamelis for a few 
days, and give the following medicines. If the limb is edem- 
atous with a stinging pain, then I give apis. But if the 
limb is sensitive and of a bright red color I give belladonna. 
If there is debility, burning pain, livid color of veins and 
varicose ulcers, then arsenicum is called for. If there is much 
pain and ulcers discharging profusely ; or dropsical legs, dis- 
charging serum, then rhtis tox. is an invaluable remedy. Pul- 
satilla is often called for when the varicose veins are painful. 
If the ulcers are deep and any danger of the periosteum of 
the bone becoming involved by caries, I then put my patient 
on biniodide of mercury for a few days followed with silicia. 
As soon as the ulcers begin to clean and tenderness begins to 
subside I atomize them with the peroxyde of hydrogen, cover 
the parts with absorbing cotton, and apply the rubber band- 
age. The bandage should be removed once a day and the 
limb bathed with warm carbolized water, or a solution of 
calendula, twenty drops to a pint of tepid water, and the 
bandage reapplied. 



294 THEORY AND PRACTICE OF MEDICINE. 

PURPURA. 

LAND SCURVY. 

This disease is divided into two varieties, i. Purpura 
simplex ; 2. Purpura hsemorrhagica. 

Purpura Simplex. — This disease is characterized by lit- 
tle round patches of a dark colored eruption, occurring chiefly 
on the thighs and legs. Those first appearing last for a few 
days, when they turn purple and disappear, followed by a 
fresh batch. The disease may last three or four weeks, or for 
several years. 

Treatment. — -Sometimes aconite is sufficient to arrest 
the further progress of the disease. If not, you may turn to 
belladonna, arnica, mercurius, rhus tox., and sulphuric acid. 

Purpura Hemorrhagica. — The symptoms in this is 
very much the same as those in the simple variety, only much 
more aggravated. The petechise are much larger, and are 
often filled with blood. The patient complains of lassitude, 
aching pains of the limbs ; dyspnoea ; despondency ; with a 
leaden hue of the skin. The slightest blow causes ecchy- 
mosis. Blood sometimes issues from every pore, the gums 
become swollen and spongy, and bleed at the slightest touch. 
I have seen the blood oozing from the eyes, ears, nose, gums, 
and from ends of the fingers. 

Causes. — Are not well understood. It is supposed that 
a diet deficient in nutriment is a cause. But it is evident to 
my mind that there is some poison generated in the system, 
by which the capillaries are so morbidly affected as to cause 
them to rupture easily on the slightest blow, or even rubbing 
the cutaneous surface. 

Treatment. — Diet is of the first importance. A mixed 
alimentation is necessary, and a change of hygienic regula- 
tions must be enforced. Lemon- juice and acid fruits must be 
taken. 



THEORY AND PRACTICE OF MEDICINE. 295 

Arsenicum. — Eruption resembling red petechias ; black 
vesicles causing burning pain ; general prostration. 

Hamamelis Virginica. — Congestions, and hemorrhages. 
Lachesis. — Bullae dark from bloody serum within. 
Sulphur. — Ecchymosis from a slight bruise. 



PURPURA NAUTIC— SCORBUTUS. 

SEA SCURVY. 

The symptoms of this disease are similar to those of pur- 
pura haemorrhagica ; they, however, are of a much more grave 
character. The patient is averse to exercise ; he feels weary, 
complains of pains in the limbs ; the breath is offensive ; the 
gums swollen, spongy and livid, bleeding at the slightest 
touch. The slightest scratch degenerates into a foul ulcer. 
Diarrhea, dysentery, putrescence, and exhaustion are frequent 
accompaniments. 

Causes. — A want of vegetable diet, or a restriction to 
a food of smoked meats. This disease used to be very com- 
mon among sailors, who used to be on the sea from three to 
six months without seeing land. Hence they were compelled 
to live exclusively on salt and smoked meats. During that 
period scurvy was very prevalent among sailors. But since 
the introduction of steam, the transit is so rapid that veg- 
etables can be carried to supply the sailors, and hence scurvy 
is rare now. 

Prognosis. — Used to be very unfavorable, but with a 
better knowledge of dietary and treatment, it is not so grave 
as formerly. If neglected it becomes a very annoying and 
dangerous disease. 

Treatment. — Bryonia and ferrum will correct some 
of the scorbutic symptoms. And the remedies given in the 
treatment of purpura haemorrhagica will be found applicable 
in this disease also. But your main reliance is in diet. The 
patient should have a full supply of vegetables, especially po- 



296 THEORY AND PRACTICE OF MEDICINE. 

tatoes, milk and vegetable acids of all kinds, should be used 
freely, such as lemon-juice, lime-juice, and tartrates. 

If diarrhea, dysentery, or any other complication should 
arise, they must be met by the appropriate remedies. 

AN^EfllA. 

This means deficiency of the red corpuscles of the blood, 
the liquor sanguinis is watery, poor in albumen, and contains 
excess of salts. 

Symptoms. — The patient looks pale and bloodless, 
and in that condition called anaemic. Sometimes the face 
looks like wax ; the gums and mucous membrane of the 
mouth look white, the tongue is pale and flabby ; the pulse 
is feeble. The patient becomes dyspeptic, weak, short of 
breath, and despondent. 

Causes. — Insufficient diet, imperfect ventilation, in-door 
exercise, and want of sunlight, are the prime causes of anaemia. 
Dr. Pollock says : " The sufferers are the victims of subter- 
raneous kitchens and back shops, and of that atrocious do- 
mestic system which deprives young women in service, of 
open-air exercise, and enjoyments, peculiar to their age. 
Secondarily, a depraved appetite arises, and tea with bread 
and butter come to form their sole diet, as all healthy desire 
for meat soon vanishes. These devitalized plants, which 
never see the sun, languish in nervous power, and furnish 
our worst cases of hysteria." 

Causes.- — Hemorrhages from any cause, leucorrhcea 
diarrhea, dysentery, ague, etc., are causes of anemia. 

Treatment. — China, acid phosphoric^ ferrum acetate, 
arsenicum, for loss of animal fluids. 

Ferrum, Pulsatilla, nux vomica and natrum sulphuricum; 
for deficient sunlight and open air exercise. 

Nourishing diet, milk, eggs, beef extracts, malted milk, or 
any thing the patient craves, with moderate out-door exercise, 
sea-bathing, etc., are all essential to the cure of the patient. 



THEORY AND PRACTICE OF MEDICINE. 297 



DIGESTIVE SYSTEM. 

Mouth, Throat, Stomach, and Intestines, 
Diseases of Mouth and Throat. 

Stomatitis Inflammation of the Mouth. 

Thrush Aphthae — Frog — Sore Mouth. 

Offensive Breath. 

Cancrum Oris Canker of the Mouth. 

Glossitis Inflammation of the Tongue. 

Ulcus Linguae Ulcer on the Tongue. 

Dolor Faucium Simple Sore Throat. 

Resolutio Faucium Relaxed Throat. 

Fauces Ulcerosa Ulcerated Throat. 

Pharyngitis Inflammation of the Pharynx. 

Cynanche Tonsillaris .... Quinsy — Tonsillitis. 
Oesophagitis Inflammation of the CEsophagus. 

STOMATITIS. 

INFLAMMATION OF THE MOUTH. 

This disease is characterized by inflammation of the whole 
mucous membrane of the mouth. The tongue, gums, cheeks 
and palate are painful and emit a fetid odor of the breath. 

Cause. — Insufficient food and clothing, and bad ventila- 
tion of children's apartments. 

Treatment. — The main thing to do is to change the 
patient's surroundings, and give plenty of fresh air and sun- 
light and a good nourishing diet. The following medicines 
will be beneficial. 

Kali chloricum {chlorate of potash). — This is indicated for 
fetid breath, patches of unhealthy ulcers on tongue and 
cheeks. 

Hydrastis. — This is indicated for a yellowish appearance 
of the tongue and cheeks. While it is being given internally 
it may be used as a mild wash. 

Mercurius. — If the child has not taken any crude mercury, 



290 THEORY AND PRACTICE OF MEDICINE. 

and there is an abundant salivation — flow of saliva — then 
mercurhis in 3X to 6x potency acts like a charm. 

THRUSH. 

SORE MOUTH — FROG. 

This is an inflammatory condition of the mouth, with little 
projections or vesicles which may end in whitish sloughs. 
The child is feverish, and the mouth is painful. The disease 
may extend to the fauces, and to the stomach and bowels, pro- 
ducing diarrhea. The glands of the neck often become swol- 
len. The prognosis is often very unfavorable. 

Causes. — Imperfect nutrition, artificial feeding with 
unhealthy milk, dirty bottles, bad ventilation, and unhealthy 
nursery. 

Treatment. — The child's whole surroundings and diet 
should be changed. 

Borax, internally and as a mild wash, is a valuable agent. 

Arsenicum. — Must be given for prostration, dark-colored 
stools, and if the patches on the mucous membrane or skin, 
become dark. 

Mercurius. — Should be administered early after the white 
vesicles appear, and especially if there is much flow of saliva. 

Borax and mercurius will cure a majority of the cases if 
given early. 

After the child is convalescing, then sidphtir should be 
given to prevent its return. 

The indigestion, if any, must be looked after. 

OFFENSIVE BREATH. 

The breath in health is pure and sweet. So when the 
breath is fetid, you may know that there is something wrong 
in the animal economy. Decayed teeth, sore mouth, nasal 
catarrh, ulcers in the throat, gangrene of the lungs, and some 
forms of indigestion are causes of bad breath. If the teeth 



THEORY AND PRACTICE OF MEDICINE. 299 

or mouth are at fault, then the teeth must be kept clean, and 
if the mouth is ulcerated, then you can have the patient wash 
the mouth and gargle the throat two or three times per day 
with either a solution of Hydrastis canadensis, ten drops to a 
goblet of water, or five to ten grains of permanganate of pot- 
ash to the same amount of water. This will give temporary 
relief until your remedies can remove the cause. 

Treatment, — Car bo veg. for decayed teeth, and un- 
healthy gums ; or if caused by salivation with crude mercury. 

Hepar sulphur. — May be used for the same condition as 
for carbo veg. 

Spigelia. — This is good for fetid breath not observed by 
the individual himself. There is much white or yellow mu- 
cus in the mouth and throat. 

Mercurius. — Is good for fetid breath from sore-mouth. 

Nux vomica or Pulsatilla may be called for when diges- 
tion is imperfect. 

Whatever is the cause of bad breath, must be sought and 
removed by the appropriate remedy. There is an offensive 
odor arising from the body of some persons which cannot be 
overcome by the most scrupulous cleanliness. That embar- 
rassing condition can almost always be overcome, and removed 
by psorinum. 

CANCRUM ORIS. 

CANKER OF THE MOUTH. 

This is a form of gangrene of the mouth occurring in 
children from two to six years old, and of a scrofulous diath- 
esis. The disease is developed by low, damp situations and 
every thing that hastens the aplastic or unhealthy diathesis. 

Symptoms. — After inflammation of the mucous mem- 
brane of the mouth has lasted a longer or shorter time ulcera- 
tion begins along the gums, the submaxillary glands become 
swollen, the breath becomes fetid, the teeth fall out, and the 
cheeks have a dark gangrenous look. After death the tuber- 
cules have been found, thus showing the cause of the disease. 



300 THEORY AND PRACTICE OF MEDICINE. 

Treatment. — If the child has not taken any crude mer- 
cury, then that agent potentized is often specific. If the 
disease has been developed by crude mercury, then nitric acid 
is the appropriate remedy. Muriatic acid is an excellent 
remedy when the cankers begin to slough. 

Arsenicum is the best remedy for gangrene and prostration. 

A mild solution of chlorate of potash, or hydrastis, is very 
soothing and healing. 

The child must have a nourishing diet, warm clothing, and 
a dry well-ventilated sleeping-room. 

DENTITION. 

TEETHING. 

This is the period that gives mothers trouble, especially 
if their children do not cut their teeth early. The first 
teeth are called milk-teeth, and they are cut any where from 
the sixth to the twenty-fourth month. The order in which 
the milk-teeth appear is generally as follows : — the two mid- 
dle incisors of the lower jaw are cut, then after a longer or 
shorter period the incisors of the upper jaw, next the outside 
incisors of the lower jaw, followed by those of the upper. 
From two to eight months the first four molars, then the eye- 
teeth, following these four other molars. The milk-teeth are 
completed about the second year. About the seventh or 
eighth year the milk-teeth are shed and replaced by the per- 
manent teeth. 

Symptoms. — Dentition is a physiological process, 
and hence in vigorous children it makes but little change in 
their system. But there is more or less disordered dentition, 
the child's gums are often swollen and tender, with much flow 
of saliva, it is peevish and fretful, has disordered stomach and 
bowels, with twitchings during sleep, and often has con- 
vulsions. 

Treatment. — Aconite for feverishness ; chamomilla is 
called for when the child is fretful, except when being carried, 



THEORY AND PRACTICE OF MEDICINE. 3OI 

but as soon as it is laid down it begins to cry. One cheek 
flushed while the other is pale. For diarrhea and constipa- 
tion. See the treatment under those diseases. 

Belladonna and chamomilla are to be given to ward off 
convulsions. 

If dentition is too early or two late then calcarea carb. is 
our main reliance. 

If the child perspires much about the head silicia is a 
valuable remedy. 

A child's gums should never be lanced, for if the milk-teeth 
do not come through at once, and the gums should heal, then 
the dentition will be more troublesome. If, however, the 
gums are swollen, purple, with blisters, then they should be 
lanced, especially if the child is threatened with convulsions. 

Milk-teeth should never be extracted until loosened by 
the pressure of the permanent teeth, for if the latter are forced 
through too soon they are apt to decay early. The dentists 
are now prepared to fill decayed teeth of children with a 
cement, and thus prevent them from aching, until they are 
loose enough to extract easily. 



GLOSSITIS. 

INFLAMMATION OF THE TONGUE. 

This affection is ushered in by heat and pain in the tongue, 
which soon begins to swell, and is often greatly increased in 
size. The face is red and swollen ; the saliva flows as freely 
from the mouth as though the patient had been salivated. 

Treatment. — Aconite and mercurius are the main 
remedies for this disease, and usually cure in a short time. If 
the tongue is much swollen and stinging pain, then apis is your 
best remedy. 

If you are called to see a patient with glossitis, and you 
find that he has been taking calomel or blue mass, then you 
may know that it is a mercurial glossitis. In that case give 



302 THEORY AND PRACTICE OF MEDICINE. 

belladonna and hepar sulphur, or nitric acid, and wash the 
mouth three times per day with a weak solution of chlorate of 
potash. 

ULCUS LINGU/E. 

ULCER ON THE TONGUE. 

This affection begins with slight pricking sensation in the 
tongue, which soon turns red in patches, and begins to swell, 
and sooner or later small ulcers form on the tongne, often but 
one ulcer appearing, but sometimes the tongue is dotted with 
them ; they usually appear on the sides of the tongue. They 
may be caused by indigestion or decayed teeth. 

Treatment. — Biniodide of mercury is the remedy par 
excellence. It may be given every two hours. I usually have 
the patient wash his mouth after each meal with a solution of 
Hydrastis canadensis, fifteen to twenty drops to a goblet of 
water. 

If the ulcers have been produced by crude mercury, then 
nitric acid must be used both internally and externally. 
Touching the ulcers with carbolic acid gives temporary relief. 



DOLOR FAUCIUM. 

SIMPLE SORE THROAT. 

This is a simple sore throat from cold, and is uncompli- 
cated with ulceration. The throat looks red and raw, and at 
first it feels dry. 

Treatment. — Belladonna is about the only remedy 
that is needed for simple cases. 

Arum tryphyllum. — This is indicated if belladonna fails 
to give prompt relief. It is indicated for constriction in the 
throat, with sneezing; soreness, burning, and pains in the 
palate. There are many other remedies that may be used, 
but those I have mentioned usually give prompt relief. 



THEORY AND PRACTICE OF MEDICINE. 303 

RESOLUTIO FAUCIUM. 

RELAXED THROAT. 

The mucous membrane and muscular tissues are relaxed, 
and have a full uncomfortable feeling, as though there was 
something in the throat that required to be hawked up. 

Treatment. — Kali bichromicum. — Soft palate, slightly 
reddened ; uvula relaxed with sensation of a plug in the 
throat. 

Lachesis. — Uvula elongated ; feeling of a lump in the 
throat, on swallowing, the lump descends, but returns at once. 

Calcarea phosphorica. — This is a valuable remedy in re- 
laxed throat. 

FAUCES ULCEROSA. 

ULCERATED THROAT. 

This is simple inflammation of the throat with ulceration. 
The ulcers may be on one or both tonsils, or they may be on 
the uvula or in the pharynx. 

Simple ulcerated throat is accompanied or preceded by 
slight headache and back-ache, and slight fever. 

Diagnosis. — It is distinguished from diphtheria, and 
scarlet fever by the mildness of the attack, and want of swel- 
ling of the tonsils and odor of diphtheria, and the ash-colored 
patches, and scarlet rash of scarlet fever. 

Treatment. — Nine times out of ten belladonna and 
biniodide of mercury will be all that will be required to per- 
form a cure, and that often within twenty-four to thirty hours. 

PHARYNGITIS. 

INFLAMMATION OF THE PHARYNX, OR CLERGYMAN'S 
SORE THROAT. 

You remember that the pharynx is the region of the 
throat behind the nose, mouth and larynx, and above the 
esophagus. 



304 THEORY AND PRACTICE OF MEDICINE. 

Symptoms. — At first the mucous membrane of the 
fauces and pharynx is irritated, followed by congestion and 
inflammation. All of the surrounding parts become more or 
less involved. The larynx often becomes painful. The 
pharynx looks raw and granulated. Sometimes the uvula is 
elongated and the fauces and tonsils are ulcerated. Thus it 
becomes a more severe and complicated disease than the sim- 
ple ulcerated throat. 

Causes. — This condition may be induced by over use 
of the voice in speaking, also from cold damp weather. 

Treatment. — Aconite is called for in the early stage, 
for fever. 

Arnica. — Is called for when the disease is brought on by 
over use of the voice. 

Argentum nitricum. — This is indicated in chronic cases, 
especially when there is ulceration. 

Belladonna. — For bright redness of the pharynx with ul- 
ceration. 

Kali bichromicum. — Chronic ulceration, with tough stringy 
phlegm. 

Lachesis. — Constant irritation in the throat, inducing 
much hawking, and a choking sensation. 

Iodide of mercury. — Clergyman's sore throat ; pains of the 
throat extending to the ear ; throat swollen and ulcerated ; 
fetid breath. 

Phytolacca. — Hoarseness with dryness of the throat ; phar- 
ynx and fauces of a darkish or grayish appearance. 

If there is much edema, then apis is called for. The 
uvula is often elongated and requires hyoscyamus. 

CYNANCHE TONSILLARIS. 

QUINSY — TONSILLITIS. 

Inflammation of one or both tonsils may come on suddenly, 
preceded by back -ache, chilliness followed by high fever ; the 
fauces are sore and stiff, with painful efforts at swallowing. 



THEORY AND PRACTICE OF MEDICINE. 305 

The tonsils become enlarged, and of a bright red color in the 
early stage. They often swell so rapidly as to impede respira- 
tion, and the patient is often in danger of suffocation. If the 
disease is not speedily arrested, the tonsils suppurate, and 
thus often endanger the life of the patient. The disease may 
be acute and chronic. 

Treatment of Acute. — Belladonna. — Bright redness 
and soreness of the tonsils, with difficulty of swallowing. 

Baryta carb. — This remedy is supposed to prevent suppu- 
ration if given early in the attack. 

Hepar sulphur. — If this remedy is given high, it is sup- 
posed to prevent suppuration ; but if the suppurative stage 
has already supervened, then the remedy, in a low potency, 
will hasten suppuration. 

Mercurius biniodide. — Is an excellent remedy if the ton- 
sils are of a pinkish hue. 

Lachesis. — Where the left tonsil is affected, and the mu- 
cous membrane is of a livid color. If the tonsils are very 
painful, and swollen so as to impede respiration, then you 
must atomize the tonsils every one to two hours with the per- 
oxyde of hydrogen, until the patient can breathe freely. If 
there is danger of suffocation, you should insert a rubber tube 
between the tonsils, and let it hang out of the side of patient's 
mouth ; thus he will be able to continue his breathing with 
more comfort. You may puncture the tonsils with a small 
trochar if there is pus, or use an aspirator. 

Chronic Tonsillitis. — If the following remedies are per- 
severed in year after year, they will remove chronic enlarge- 
ment of the tonsils. Baryta carb., calcarea iodide, calcarea 
phosphorica, mercuriits biniodide, sepia, and silicia. It is best 
to make the selection in accordance with the symptoms, and 
after giving that remedy for a few weeks, then change to an- 
other that seems to be indicated. After your patient is well 
under the influence of the remedies, and the tonsils become 
spongy, the following will hasten the reduction of the tonsils. 



306 THEORY AND PRACTICE OF MEDICINE. 

Iodide of zinc one drachm ; aqua dist., four ounces. Mix 
and use with an atomizer to tonsils at bed-time each night for 
awhile, then drop off to twice a week. 

If your patient is in the strumous diathesis, then he must 
be nourished well with milk, eggs, fresh meat and malted 
milk. If he is able to spend the winter in Florida, it will 
greatly facilitate the removal of the tonsils and the scrofu- 
lous diathesis. 

OESOPHAGITIS. 

INFLAMMATION OF THE ESOPHAGUS. 

Inflammation of the esophagus is almost always the re- 
sult of swallowing poisons, or irritating substances, or inflam- 
mation may extend from the fauces. 

Rheumatism of the gullet may occur when a patient is af- 
flicted by rheumatism in other parts of the body. Its presence 
is indicated by painful deglutition referred to some part of the 
gullet. "Spasmodic actions of the esophagus is of frequent 
occurrence. It is characterized by difficulty of swallowing 
with a choking sensation. The food or drink suddenly stops, 
but after a few seconds the spasm is broken and the patient 
can swallow as usual. There is often a permanent stricture 
of the esophagus, which is at first made manifest by slow 
difficult swallowing. This continues for some time, when the 
patient is unable to swallow any more without the surgeon's 
aid. The daily introduction of a bougie, will prolong the 
patient's life ; and sometimes it may be removed if the strict- 
ure is not the result of cancer. 

You diagnose the spasmodic stricture from the fact that it 
is of short duration, while the organic stricture is permanent. 
Treatment. — If inflammation of the esophagus is due 
to an extension of disease from the pharynx or tonsils, then 
the treatment is the same for all. If there is a painful spot, 
then some of the rheumatic remedies are necessary. If the 
esophagus is swollen and the pain is stinging, then apis is 
the remedy. 



THEORY AND PRACTICE OF MEDICINE. 2>°7 

Gelsemium. — Has painful sensation of a lump in the esoph- 
agus, and burning in the stomach. 

Veratrum viride, — Burning in fauces and esophagus, with 
constant inclination to swallow. 

Spasmodic Stricture of the Esophagus. — Gelsemium. 
— Dysphragia ; or difficulty of swallowing from spasm of the 
esophagus. 

Veratrum viride. — Spasm of the esophagus, with or with- 
out rising of frothy or bloody mucus ; sensation of a ball ris- 
ing in the esophagus. 

PAROTIDES. 

MUMPS. 

Parotitis is singular and means an inflammation of the 
parotid gland. Parotides is plural and signifies an inflamma- 
tion of the parotid glands, called mumps. The parotid glands 
are beneath and in front of the ear. 

Causes. — Mumps is due to a specific contagious virus. 
Cold, iodism, and mercurial salivation may produce non-con- 
tagious parotitis. 

Symptoms. — The jaws feel stiff and sore when they 
are moved, eating becomes painful, one or both parotid 
glands become enlarged and painful. The patient is feverish 
with more or less headache. As the disease progresses the 
other glands about the neck often become involved. The. 
disease usually runs its course in about a week or ten days. ■ 

Prognosis. — This is generally favorable in healthy in- 
dividuals. If a patient is exposed to cold the swelling of 
the neck may subside, and the testicles in the male, and the 
mamma in females, may be attacked by metastasis, and thus 
the disease may become very serious. 

Diagnosis. — The diagnosis is not difficult when we re- 
member that the parotid glands lie beneath, and in front of 
the ear, so if the swelling begins in front of the ear then we. 



308 THEORY AND PRACTICE OF MEDICINE. 

know that we have parotitis. By taking a little vinegar in 
the month, if the disease is mumps, then it causes spasm of the 
jaw, and the patient can hardly swallow. 

Treatment. — If a patient is feverish he may have a few 
doses of aconite. But usually the case only requires mercn- 
rius cor., or the mercuriiis biniodide is all that will be neces- 
sary. But if erysipelatous inflammation should supervene, or 
the head become involved, then belladonna, gelsemium, or 
hyoscyamns may be indicated. 

If there is metastasis to the testicles or mamma, then Pul- 
satilla is a valuable reined}', also clematis and spongia often 
prove beneficial. 

I have found the following prescription to act beneficially 
in allaying pain and reducing the swelling. Aconite leaves, 
belladomia leaves, each half an ounce ; muriate of ammonia, 
half an ounce ; put into a quart of boiling water, and when 
cool enough to use then saturate cloths and apply to testicles 
and mamma and renew as often as they get dry. 

The patient should be kept warm and comfortable, and 
during the swelling stage the neck should be kept covered 
and warm. 



THEORY AND PRACTICE OF MEDICINE. 309 



DISEASES OF THE STOMACH. 

Gastritis Inflammation of the Stomach. 

Dyspepsia Indigestion. 

Gastralgia Pain in the Stomach. 

Pyrosis Water-Brash. 

H^ematemesis Vomiting of Blood. 

Carcinoma of the Stomach. . . Ulceration and Perforation 

of the Stomach. 



GASTRITIS. 

INFLAMMATION OF THE STOMACH. 

This disease is characterized by an inflammatory condi- 
tion of the stomach, and is of three grades : Acute, subacute 
and chronic. The disease is often ushered in by vomiting, 
burning pain, tenderness upon pressure at the pit of the stom- 
ach and fever, with intense thirst for cold drinks. The tongue 
is red at first, but becomes dry and brown. This disease 
may end in resolution, or in chronic gastritis. In gangrene ; 
in ulceration, followed by perforation. 

Causes. — Drinking of ice-water when the body is over- 
heated. Acute gastritis is a rare disease except when in- 
duced by swallowing irritants and poisons. Subacute or 
chronic is of frequent occurrence among habitual drinkers^ 
and certain kinds of indigestible food. 

Diagnosis. — The nausea and vomiting, with severe pain 
and tenderness of the stomach and high fever, leave no doubt 
as to the trouble. The absence of fever and the tumefaction 
in the stomach, point to cancer instead of gastritis. 

Prognosis. — If the pulse becomes 1 ess frequent and soft 
and the pain and tenderness growing less, then our prog- 
nosis should be favorable ; but if your remedies do not make 
a favorable impression in a reasonable time, and the tender- 
ness extends to the bowels, then it is unfavorable. 



310 THEORY AND PRACTICE OF MEDICINE. 

Pathology. — The mucous membrane is red or of a dark 
red color, patches of dark ulcers are found in every portion 
of the stomach. In drunkards the mucous membrane is of a 
dark purple, with patches of ulceration. 

Treatment. — Aconite. — High fever, intense thirst for 
large draughts of water ; sharp cutting pains in the stomach ; 
bitter bilious vomiting. 

Arnica. — Painful pressure in the stomach; vomiting of 
dark, coagulated blood after internal injuries. 

Arsenicum. — Heat or burning in the stomach, with sharp, 
shooting pains ; vomiting of everything eaten or drank ; dur- 
ing the vomiting, violent pain in the stomach ; wants to drink 
often and but little at a time. 

Patient may be allowed crushed ice at short intervals. A 
cold compress over the region of the stomach is very benefi- 
cial, and often grateful. The patient may take only a few 
spoonfuls of milk at a time. It would be better to nourish 
the patient with enemas of beef extract until the stomach is 
retentive. 

Subacute and Chronic Gastritis. — These must be 
managed upon the same general principles as I have laid 
down for the acute variety. 

Bryonia. — Region of the stomach very sensitive to pres- 
sure ; burnings in the stomach ; vomiting immediately after 
eating or drinking ; nausea and f aintness from sitting up in 
bed. 

Iris versicolor. — Great burning distress in the epigastric 
region ; nausea and vomiting, with pain in the stomach ; ag- 
gravation by motion. 

Phosphorus. — As soon as water gets warm in the stomach 
it is thrown up. 

There are many other remedies that are often indicated, 
but those I have mentioned will tide your cases over the worst 
symptoms. You must remember that the remedies mentioned 
for the acute may also be beneficial in the subacute and 
chronic varieties. 



THEORY AND PRACTICE OF MEDICINE. 3II 

DYSPEPSIA. 

INDIGESTION. 

This disease is characterized by the loss of power of the 
alimentary canal to digest and assimilate food when taken into 
the stomach. The symptoms are so variable that I need not 
take up your time in delineating them, but as I point out the 
indicated remedies you will readily understand the various 
symptoms that may arise. 

Anacardium. — Symptoms disappear while eating, and re- 
turn soon after (better after eating, hepar ; worse after, ar- 
senicum, nux vomica.) 

Arsenicum. — Nausea and vomiting after eating or drink- 
ing ; burning and pressure as of a stone in the stomach. 

Bryonia. — Soreness over the region of the stomach. Every 
thing tastes bitter ; (Pulsatilla, tastes sour, china, nux) ; food 
is thrown up immediately after eating. 

Calcarea carb. — Want of assimilation ; vomiting of the 
ingesta, which tastes sour ; cold damp feet. 

Carbo veg. — Sensation as if the stomach and abdomen 
would burst when eating or drinking ; sour rancid belchings, 
and burning in the stomach. 

China. — Abdomen feels full and tight, as if stuffed, eruc- 
tations affording no relief ; {argentum nitricum affords marked 
relief.) 

Lycopodium. — After taking a mere swallow of food, feels 
full up to the throat ; constant sense of fermentation in the 
abdomen, like yeast working ; much rumbling, particularly in 
the left hypochondria. 

Pulsatilla. — Flatulency in the stomach ; eructations after 
a meal, tasting of the food last eaten. 

Robinia. — Indigestion with heart-burn and acidity ; vomit- 
ing of very sour fluid setting the teeth on edge ; great dis- 
tention of stomach and abdomen, with flatulence and severe 
colic. 



312 THEORY AND PRACTICE OF MEDICINE. 

GASTRALGIA. 

PAIN IN THE STOMACH. 

This condition of the stomach is called gastralgia, gastro- 
dynia, and cardialgia. It simply means pain or spasm of the 
stomach. It is sometimes excruciating. 

Treatment. — Aconite. — Sudden excruciating pain with 
gagging, retching, vomiting of blood, gasping ; cold sweat on 
forehead. 

Abrotanum. — Pains cutting, gnawing, burning. 
Acid hydrocyanic. — Violent pain in stomach, with loss of 
speech. 

Arsenicum. — Pain and vomiting after food. 

Bismuth. — Burning pain and vomiting. 

Chamomilla. — Spasm with stinging pain in pit of stomach. 

Nux vomica. — Violent pain in stomach running upward. 



PYROSIS. 

W A T E R-B RASH. 

This is characterized by eructations of copious quantities 
of a tasteless watery fluid. It is produced by muscular spasm 
of the esophagus, which prevents the saliva from passing 
into the stomach. It is a very unpleasant sensation. It is 
commonly due to gastric catarrh, but may be induced by or- 
ganic disease of the stomach and liver. 

Treatment. — Carbo veg, — Pyrosis, great flow of water 
from mouth. 

Lycopodium. — Nausea in pharynx ; heart-burn ; water- 
brash. 

Nux vomica. — Heart-burn ; water-brash ; , worse before 
breakfast. 



THEORY AND PRACTICE OF MEDICINE. 313 

HEMATEMESIS. 

VOMITING OF BLOOD. 

This is generally preceded by nausea, distress or pain of 
the stomach. The hemorrhage may be acute or chronic. 

Prognosis. — The acute vomiting of blood is not always 
dangerous, as it may be due to slight congestion of the mu- 
cous membrane. The chronic is more grave, as it may be the 
result of organic disease. 

Diagnosis. — The only question to be solved, is whether 
the blood comes from the stomach or lungs. The following 
table will enable you to make the distinction. 

FROM THE STOMACH. FROM THE LUNGS. 

i. In Hematemesis the blood of a 1. In Hemoptysis the blood is of 
dark color. a bright-red color. 

2. The blood is vomited. 2. The blood is generally coughed 

up. 

3. The blood is often mixed with 3. The blood is generally frothy 

food, and is not frothy. and mixed with sputa. 

4. Is preceded by nausea and 4. Is often preceded by pain in 

stomach distress. the chest and dyspnoea. 

5. Blood is generally passed with 5. Blood is not found in the stools. 

the evacuations from the 
bowels. 

Treatment. — The patient must be kept cool and in 
the fresh air ; all tight clothing must be unloosened, and the 
patient allowed to swallow bits of ice. 

Aconite. — Hemorrhage with flushed face ; palpitation and 
anguish. 

Hamamelis. — This is an invaluable remedy for hemor- 
rhage from any part of the body, and especially from the 
stomach. 

China. — After hemorrhage has taken place, and the pa- 
tient is pale, with feeble pulse, cold feet and hands, fainting, 
then china is your main remedy. 

Ipecacuanha. — Bright-red blood, with paleness of the face, 
and nausea. 



314 THEORY AND PRACTICE OF MEDICINE. 

Arsenicum. — Vomiting of blackish bile and blood. 
Veratrum album has the same symptoms as arsenicum. 
Arnica is given for mechanical injury of the stomach. 

Ulceration and Perforation of the Stomach. 

This disease is quite common, especially among high 
livers and drunkards, and is often mistaken for some forms of 
dyspepsia. 

Symptoms. — There is generally a burning pain in the 
back opposite the stomach. The stomach is tender to the 
touch, with slight nausea. Pain worse after taking solid 
food. The patient often complains of water-brash, and vom- 
iting of food and mucus, which gives temporary relief. The 
disease is not dangerous unless perforation takes place, then 
it becomes a fatal complication. It is rare that simple ulcers 
of the stomach prove fatal. 

Diagnosis. — It is sometimes difficult to distinguish be- 
tween chronic inflammation, and ulceration of the stomach, 
and some forms of dyspepsia. Simple chronic inflammation 
of the stomach is not so painful as ulceration ; neither is dys- 
pepsia. You almost always get inflammation before ulcera- 
tion, hence the treatment is about the same. By a close in- 
spection of the stomach you can generally detect a thickening 
of the muscular coats, or some degree of tumefaction, which is 
diagnostic of carcinoma, or cancer, of the stomach. 

Treatment. — Argentum nitricum. — Excessive pain in 
the left side of stomach, worse from touch and deep inspira- 
tion ; especially prominent at night. 

Arsenicum. — Pain excessive, pressive, burning in the cavity 
of the stomach, vomiting of every thing taken ; vomit is mixed 
with blood. 

Kali bichromicum. — Excessive pain in the stomach, at 
night, and vomiting of alimentary substances, and blood. 
This remedy has been known to produce ulceration of the 
stomach, and hence it is homoeopathic to that condition. 



THEORY AND PRACTICE OF MEDICINE. 315 

Kreosotum. — This remedy is used both for cancer and ulcer- 
ation of the stomach. It is indicated by pain and vomiting. 

Phosphorus. — Is indicated by gnawing and cramp-like pain 
in the stomach, with vomiting of food and blood. 

Uranium. — Vomiting of food, with agonizing, burning 
pain in the stomach. 



CARCINOMA OF THE STOMACH. 

CANCER. 

This disease is characterized by severe pain in the stomach 
with vomiting of food and a glarious or brownish substance. 
It is generally diagnosed from ulcer of the stomach, in view of 
the fact that cancer produces a tumefaction of the epigastric 
region, or a small tumor is felt in some portion of the stomach. 
A cancerous patient usually has a peculiar yellowish leaden 
hue of the face. 

Treatment. — The remedies which I have mentioned 
for ulcerated stomach, are also our best remedies for cancer of 
the stomach. 

Without going into a detailed description of the various 
forms of cancer, I will only mention a few remedies that are 
indicated for the various forms. 

Arsenicum is a valuable remedy in almost all forms of 
cancer. 

Aco7iite is valuable to allay the pain produced by cancer. 

Hydrastis is highly beneficial for cancer of the upper lip 
and tongue. Also, when the glands and uterus are dark and 
cancerous. 

Conium maculatum is a valuable remedy, both internally 
and externally, for open cancer of the breast. 

I wish to say here that many tumors of the breast have 
been mistaken for cancer, which I was able to cure with reme- 
dies indicated for scrofulous glandular swellings. Hence I 
condemn the habit of amputating the breast until the reme- 



316 THEORY AND PRACTICE OF MEDICINE. 

dies for scrofula have had a fair trial. Even in cancer an 
operation is unnecessary unless there is intense suffering. The 
operation will give temporary relief, but if it is a cancer, it will 
certainly return, and if the patient gets well it is evidenced 
that it was not a cancer ; that has been my experience. 

If a scrofulous breast is very large and ulcerated, then I 
would advise an amputation, for the drain upon the system 
might prove fatal the same as if it was a cancer. 

Drs. Beebe, of Chicago, and Pease, of Boston, claim to 
have tine success with carbolic acid in the treatment of cancer. 

Epithelial cancer often requires thuja. 

Cancer of the tongue is said to have been greatly relieved 
by the use of galiiim aparine. It is supposed to favor granu- 
lations. 

Hydrocotyle asiatica is said to benefit uterine cancer, I 
have never used it. 

Dr. Craig thinks that sangiiinarea canadensis has a ten- 
dency to lessen the return of cancer after excision. 

I wish that I could give more encouragement for the cure 
of cancer, but after a long experience I can only say that the 
chances of cure are not nattering, but I can say that homoeo- 
pathy prolongs life, and gives more comfort than all other 
treatments combined. 



THEORY AND PRACTICE OF MEDICINE. 317 



DISEASES OF THE STOMACH 
AND INTESTINES. 



Gastro Enteritis Mucosa. . . .Simple or Sporadic Cholera. 

Cholera Maligna Malignant or Asiatic Cholera. 

Cholera Infantum Cholera of Infants. 



CHOLERA SIMPLEX. 

SIMPLE OR ENGLISH CHOLERA — SPORADIC CHOLERA — 
CHOLERA MORBUS. 

This disease is characterized by a sudden attack of vomit- 
ing and purging, usually in the night. The discharges are 
bilious, and if unchecked may be followed by cramps in the 
stomach and bowels, and collapse. It is rare, however, that a 
patient dies from cholera morbus. 

Treatment. — Camphor.— Vox first stage with chills. 
As a rule, arsenicum and veratrum album are the first and 
only remedies needed in cholera morbus. 

Arsenicum. — Has violent vomiting of green-yellow liquid ; 
sometimes the vomit is brown and turbid ; often black ; stools 
at first are green, then yellow and black, with severe crampings 
in stomach and bowels. 

Veratrum album. — Has violent vomiting of thin, blackish 
or yellowish substances, with long continued nausea, vomit- 
ing and purging simultaneously ; coming on at night ; stools 
watery, and greenish ; cold sweat on the forehead. 

Arsenicum and veratrum albimi both arrest exosmosis, and 
hence cure the patient. 



318 THEORY AND PRACTICE OF MEDICINE. 

CHOLERA MALIGNA. 

MALIGNA OR ASIATIC CHOLERA. 

This is a specific malignant disease, which is perennially 
endemic in India, and is thence propagated, and becomes epi- 
demic by means of contagion and atmospheric currents. Its 
diffusion appears to depend on certain meteorological condi- 
tions — a warm, moist, stagnant, and oppressive condition of 
the atmosphere. 

Symptoms. — The First or Premonitory Stage. — 
This is often so slight as to be overlooked by the patient. 
Usually, however, there is some degree of lassitude, nausea, 
and painless diarrhea. 

Second or Cold Stage. — This may be preceded by the 
symptoms of the first stage ; or the second stage may be 
ushered in suddenly, and it generally comes on from twelve 
to three o'clock in the morning. The patient is aroused by 
nausea, vomiting, and purging of serous, or rice-water dis- 
charges. Rapid prostration supervenes, the pulse is intermit- 
tent, the pupils of the eyes are contracted ; there is intense 
thirst, with a burning sensation in the stomach ; the muscles 
of the thighs, and calves of the limbs begin to cramp and form 
hard muscular knots ; the surface of the body begins to feel 
cold and damp ; the tongue and breath become cold. 

Third Stage or Collapse. — The patient is nearly pulse- 
less ; the lips are purple, the tongue is cold and livid ; the eyes 
are sunken ; the countenance livid, the skin is bathed with a 
cold clammy sweat ; the voice is low, feeble, and unnatural ; 
the patient is extremely restless ; collapse and death close the 
scene. Patients usually die between the hours of 7 and 11 
A. m., and 7 and 11 p. m. 

If the patient survives the cold stage eighteen hours there 
may be favorable symptoms developed, or febrile symptoms 
may supervene, lasting a short time, followed by a warm perspi- 
ration ; in that case the patient makes a slow recovery. If the 



THEORY AND PRACTICE OF MEDICINE. 319 

algid condition continues and the cramps are severe then your 
prognosis is most unfavorable. 

Treatment. — First Stage. — Camphor \s indicated for 
the choleric diarrhea with cold chilly sensation, and spasmodic 
pains in the abdomen. 

Aconite. — Is also a valuable remedy in the invasive stage 
of cholera, and often cuts short the disease. It is indicated 
when there is violent heat and dryness of the skin ; full and 
frequent pulse ; bitter, greenish vomiting ; stools whitish. 

It is supposed that camphor antidotes the bacteria or bacil- 
lus. If that be true, then camphor should be given in drop 
doses of the mother tincture on a lump of sugar for a short 
time before resorting to the regular treatment, unless the symp- 
toms call for other remedies in preference to camphor. Dur- 
ing an epidemic of cholera it is supposed that camphor is a 
prophylactic, and should be taken once a day by the profes- 
sion and the laity. 

Second STAGE. — If camphor has failed to arrest the dis- 
ease in the first stage, then you must resort to either arseni- 
cum, cuprum, or veratrum album, and make a judicious selec- 
tion in accordance with the symptoms present. 

Arsenicum. — Is called for where there is sudden and ex- 
treme prostration ; violent vomiting of watery, slimy, greenish, 
or blackish substances ; vomiting and purging simultaneously ; 
violent pains in the stomach. 

Cuprum. — Violent vomiting, with colic and diarrhea. The 
grand characteristics for cuprum in cholera is the violent 
cramps in the stomach, fingers and toes ; also in the calves. 

Veratrum album. — Violent vomiting and purging simul- 
taneously with profuse gushing rice-water discharges. The 
matter vomited is blackish or of a yellowish color ; cramps in 
the calves, followed by rapid prostration ; cold breath ; cold 
sweat over the whole body. 

Ipecac. — Vomiting of large quantities of green jelly-like 
mucus, or black pitch-like substances ; grass-green mucus 
stools ; cramps in the calves, fingers and toes. 



320 THEORY AND PRACTICE OF MEDICINE. 

Third or Collapsed Stage. — Arsenicum and car bo veg. 
are your main reliance in this stage. The patient wants to 
be stimulated with strong coffee. A tablespoonful of strong 
coffee, say four times as strong as that for table use, may be 
given every fifteen to thirty minutes, till pulse begins to re- 
spond. If given clear, without milk or sugar, coffee is an ex- 
cellent remedy to arrest some forms of vomiting. 

The reason why there is so much fluid substance thrown 
out of the stomach, and pass through the bowels during an 
attack of cholera, is due to the fact of exosmose. That is to 
say, the watery elements of the blood pass directly from the 
capillaries into the stomach and bowels by exosmatic action, 
and hence the rapid drain upon the system, and early prostra- 
tion of the patient. It is a well-known fact that exosmose and 
endosmose will take place when a fluid is placed in contact with 
animal tissue. It is also a demonstrated fact that when the 
animal tissue is saturated with salt, the exosmatic and endos- 
matic action is suspended. This being true, then, we infer 
that salt may be used to advantage in the treatment of cholera. 
Patients in that disease have intense thirst, owing to the rapid 
passage of the watery elements of the blood by exosmose to the 
interior of the stomach and bowels. Now then, by placing a 
small amount of salt into the drinking water, the stomach is 
soon saturated with the saline elements, and thus prevent exos- 
mose from the capillaries into the stomach. A quart of warm 
salt water may be thrown into the colon, and held there by 
compress for a few minutes, until the mucous coat of the colon 
is saturated, and thus prevents exosmose of the water from the 
blood into the colon. At the same time the salt and water is 
being absorbed, and taken into the circulation, and the blood 
thus becoming saline, exosmatic action of the tissues is ar- 
rested, and thus the blood retains water enough to keep it in 
its normal condition, and thus life is prolonged. 

Arsenicum, veratrum album and other agents, are homoeo- 
pathic to cholera, owing to the fact that their physiological 
action produces an exosmatic condition of the tissues of the 



THEORY AND PRACTICE OF MEDICINE. 321 

stomach and bowels. Some modern authors are using the 
term osmose instead of exosmose. 

Typhoid Condition. — This is met by the use of phospho- 
rus, arsenicum, car bo veg., and nitric acid. 

Absolute rest of body and mind is essential to the success- 
ful treatment of cholera. The diet must consist of small 
amounts of milk and beef essence. If the stomach is not re- 
tentive then the nourishment can be given per rectum. The 
patient must be kept warm, but should have free ventilation. 

All I need say to you on the prevention and spread of 
cholera is to enforce absolute and sanitary and hygienic mea- 
sures. 

CHOLERA INFANTUM. 

This is a disease peculiar to infants, and it resembles the 
algid or epidemic Asiatic cholera in the adult. 

Symptoms. — Diarrhea is often the first symptom no- 
ticed, but vomiting and purging, together with raging thirst, 
is soon developed. The ejections from the stomach and 
bowels may be greenish, yellowish, brownish, or rice-water 
colored. The brain soon becomes involved, the head is hot 
and dry, eyes suffused, the child is restless, or it may become 
comatose. It loses flesh rapidly ; it may be fat and plump, 
and in thirty-six hours it may become a mere skeleton, and 
die within that time. The disease often runs two or three 
weeks before recovery is complete. 

Causes. — The predisposing causes are teething, im- 
proper food, sour nursing-bottles and nipples. The exciting 
causes are excessive summer heat, and crowded population in 
large cities, and unsanitary surroundings. 

Prognosis. — While under homoeopathic treatment, 
thousands of children have been saved, which under almost 
any other plan of treatment might have been lost, yet our 
prognosis must be guarded, for it is a very fatal disease in 
some epidemics. I believe if parents could be taught the im- 



322 THEORY AND PRACTICE OF MEDICINE. 

portance of calling a physician in the first stage, that a large 
majority of cases might be saved. But the trouble is, that so 
many people have the opinion that if a child is teething, its 
bowels should not be checked, and hence the physician is 
often not called until the chance of recovery has passed, and 
then the doctor is abused because he cannot raise the dead. 

Treatment. — The physician's skill is taxed to its utmost 
limit, for the life of the patient hangs upon two contingencies, 
the stage of the disease in which he is consulted, and a judi- 
cious selection of the indicated remedy, for we have no time 
to guess and try our agents for the exigency demands prompt 
and energetic measures. I will now give some of the grand 
characteristics of our remedies in case of emergency. 

Aconite. — Fever, nausea and vomiting ; stools green, watery, 
with cutting pain before, during, and after evacuation. 

ALthusa. — Violent vomiting of coagulated milk ; spasms, 
with stupor and delirium, clenched thumbs, eyes drawn down- 
ward, pupils dilated. 

Apis. — Stools greenish, yellowish, slimy mucus ; during 
stool, griping and tenesmus ; abdomen tender to pressure. 

Arsenicum. — Stools thick, dark, green mucus, or dark, 
watery , offensive ; vomiting, restlessness, extreme prostration ; 
worse after midnight. 

Belladonna. — Stools thin green mucus, or bloody mucus; 
delirium ; worse during and just after sleep, with desire to get 
out of bed ; sleepy, but cannot sleep, sudden starting and 
jumping during sleep. 

Benzoic acid. — Stools copious, water}', grayish- white, like 
dirty soap-suds, and very offensive ; dark strong-smelling urine. 

Borax. — Stools watery, light yellow, slimy mucus, or green- 
ish ; fear of falling from downward motion. 

Bryonia. — Wants large draughts of water at long intervals ; 
vomiting of food as soon as taken ; turns sick and faint on 
moving. 

Calcarea carb. — This is an invaluable remedy for scrofu- 
lous children with large abdomen and emaciated limbs ; a want 



THEORY AND PRACTICE OF MEDICINE. 323 

of assimilation ; whitish, watery, or chalk-like stools, undi- 
gested ; profuse sweat on the head when sleeping ; cold, damp 
feet. 

Carbo veg. — Stools light colored ; involuntary ; putrid, 
cadaverous smelling. 

Chamomilla. — Green, watery ; corroding stools, white and 
yellow mucus, like chopped eggs, with colic ; child fretful 
unless carried ; one cheek red and the other pale. 

China. — Abdomen distended ; stools yellow, watery, pain- 
less, or blackish and offensive. 

Cina. — White stools, urine white and turbid ; restless 
sleep ; waking with cries ; grinding of the teeth during sleep. 

Croton tiglium. — Dry, parched lips ; nausea and vomiting 
of water, mucus and bile ; stools yellow, watery, dark-green, 
or greenish-yellow, coming out like a shot. 

Ipecac. — Constant nausea and vomiting of green mucus ; 
stools grass-green mucus, or white, fermented. 

Jatropha. — Profuse watery stools, gushing out like a tor- 
rent ; vomiting of dark-green bile or watery, albuminous sub- 
stances ; liquid gurgling in the abdomen. 

I learned by experience the importance of prescribing in 
accordance with the symptoms. After prescribing several 
remedies without any result, I was sitting by the child when 
I , heard the gurgling of liquid in the abdomen, I then pre- 
scribed jatropha, and the child was relieved within twenty-four 
hours; it saved the child's life. 

Laurocerasus. — Pulse irregular or imperceptible ; stools 
green, liquid, mucus, involuntary ; cutting pain in the abdo- 
men before, and tenderness after stool. When the patient 
takes liquids they produce a rattling sound when passing 
through the esophagus. 

Mercurius. — Stools yellow as sulphur, sometimes green 
slimy, or bloody ; colic before, and violent tenesmus during, 
and after stool. 

Nux moschata. — Stools thin, yellow, like beaten eggs ; 
colic before, and urging during stool. 



324 THEORY AND PRACTICE OF MEDICINE. 

Nnx vomica. — Frequent, small, watery, slimy, dark-colored, 
mucus stools ; violent straining at stool ; relief after stool. 

Phosphorus. — Drinks thrown up as soon as they get warm 
in the stomach ; stools white, watery, containing little lumps, 
like grains of sago or tallow. 

Podophyllum. — Gagging or empty retching ; stools watery, 
with meal-like sediment ; dark-yellow mucus, smelling like 
carrion ; profuse watery, painless, stools ; very exhaustive. 

Thuja. — Stools pale-yellow, watery, very copious, and gush- 
ing out like water from a bung-hole. 

Veratrum alburn. — Vomiting, excited by the smallest 
quantities of liquids ; stools greenish, watery, with flakes ; se- 
vere colic ; during stool, cold sweat on the forehead. 

The foregoing remedies with the characteristic stools are 
beneficial for the adult, as well as for children. 

If the mother is healthy, and her milk is pure, that is the 
best diet the child can have. But if it does not agree, then 
malted milk, pure milk from one cow, or condensed milk, 
must be resorted to to nourish the child. Beef essence is 
nutritious and an organic stimulant. 



THEORY AND PRACTICE OF MEDICINE. 325 



DISEASES OF THE INTESTINES. 



Enteritis Inflammation of the Intestines. 

Duodenitis inflammation of duodenum. 

C^ecitis — Typhelitis — Appendecitis . . Inflammation of the Caecum. 

Diarrhea Purging. 

Dysenteria Dysentery. 

Mel/ena Haemorrhage from the Bowels. 

Torpor Intestinorum ' : - .Constipation. 

Colica Colic. 

Colica Pictonum Painter's Colic. 

Tympanitis Drum Abdomen. 



ENTERITIS. 

INFLAMMATION OF THE INTESTINES. 

This is a disease, as its name implies, in which a part or 
the whole of the intestines may be involved, including all the 
coats. The mucous coat may also be involved ; in that condi- 
tion it is termed muco-enteritis, and usually attacks children 
from six to eight months old. 

Symptoms. — This disease is ushered in by rigors, fol- 
lowed by fever, tenderness and pain in the abdomen, usually 
around the navel. The abdomen is tender to the touch, and 
often becomes tympanitic. The patient lies on his back, 
with knees drawn up to relax the abdominal muscles, and to 
keep the bed-clothing from pressing upon the tender parts. 

The bowels are usually costive in the beginning ; nausea 
and vomiting are present. 

Pathology. — As might be expected we find all of the 
coats of the intestines and cellular tissue involved. Disinte- 
gration and gangrene is the result of fatal cases. 

Causes. — Cold; unripe fruit eaten to excess; use of 
strong drinks, irritating substances, indurated feces. 



326 THEORY AND PRACTICE OF MEDICINE. 

Diagnosis. — The local tenderness around the navel 
distinguishes this disease from peritonitis, in which the tend- 
erness is more general. In the early stages of colic, there is 
little or no tenderness upon pressure, while the reverse is true 
in enteritis. And then again, there is little or no fever in 
colic. 

Prognosis. — Favorable. — Gradual abatement of all 
the symptoms. 

Unfavorable. — Increase of swelling and pain, hiccough 
ensues, pulse becomes irregular, skin is covered with a cold 
sweat ; collapse, cessation of pain, and death takes place from 
exhaustion. 

Treatment. — From my own clinical experience, I do 
not hesitate to say that aconite and mercurius cor. are our 
main remedies. For I tell you that you have an ungrateful 
monster to deal with when you attack enteritis, and if you 
dally away a few hours of your precious time you may lose a 
precious life that might have been saved. While many of 
the books say but little about ?nercurius cor. in enteritis, yet 
it is, par excelleiice, homoeopathic to the whole of the alimen- 
tary canal. 

Arsenicum. — Severe burning pains around the umbilicus, 
obstinate vomiting, and excessive prostration. Intense thirst, 
drinking often, but little at a time. 

Bryonia. — Stitching or lancinating in the bowels, worse 
from the slightest motion ; lies perfectly quiet, does not want 
to move ; hard sore swelling around the umbilicus ; great 
thirst for large draughts of water at long intervals. 

Cantharis. — Violent burning thirst, with aversion to all 
kind of drinks ; tenesmus of the bladder, with ineffectual ef- 
forts to urinate. 

Veratrum album. — Great thirst ; furred tongue ; nausea 
and vomiting ; severe prostration ; extremities cold. 

In the early stage of the inflammatory process a cold com- 
press is soothing and greatly allays the heat and inflamma- 
tion. Towels saturated with cold water, and wrung nearly 



THEORY AND PRACTICE OF MEDICINE. 327 

dry, may be spread over the abdomen, and covered with dry 
flannel. The patient must return to solid food very grad- 
ually and carefully. 

DUODENITIS. 

Inflammation of the duodenum may be either acute or 
chronic. This organ is so closely attached to the stomach, 
that without proper care the trouble may be located in the 
stomach, instead of the duodenum. 

Treatment. — Arsenicum. — Is indicated for tenderness 
and burning over the course of the duodenum. 

Kali bichromicum. — This remedy has a specific action on 
the duodenum ; the tongue may be thickly coated with a white- 
brown fur, bitter taste, and pale stools. 

• Podophyllum. — This is indicated in duodenitis when com- 
plicated with affections of the biliary ducts, and tendency to 
jaundice. 

INFLAMMATION OF THE C/ECUM. 

C^ECITIS — TYPHLITIS — APPENDECITIS. 

This is an inflammation of the lower portion of the ascend- 
ing colon, called the caecum. It is also called typhlitis, from 
the Greek word " tuphlos" which means blind. It is now called 
appendecitis. 

The pain and tenderness are referred to the right ileo-cae- 
cal region. Sometimes the pain is excruciating, and unless 
the inflammation is speedily arrested an abscess will form. 
This, however, ought not to occur under homoeopathic treat- 
ment if the patient is seen in time, and the trouble is recognized. 
Treatment. — Lachesis. — Cutting pains in right side of 
abdomen, causing fainting attacks ; swelling in the csecal 
region ; must lie on the back with limbs drawn up. I had a 
case in which after all other remedies had failed I determined 
to try lachesis before resorting to an operation. It relieved 
pain within a few hours, and the patient recovered. 



328 THEORY AND PRACTICE OF MEDICINE. 

Mercurius. — Hard, painful, hot swelling in the ileocaecal 
region. 

Veratrum viride. — Pains at right of umbilicus, passing 
down to groin. 

Saturate a cloth with a lotion of one drachm of the tinc- 
ture of veratrum viride to a goblet of water, and apply over 
the csecal region. A warm or cold compress may be applied 
over the cloth containing the lotion. If there is much pain a 
hot compress gives more relief. But in the beginning of the 
inflammatory process, the cold compress allays heat and pre- 
vents suppuration. If an abscess forms, then you must aspi- 
rate early before it bursts internally. Operate on the appen- 
dix early, when your remedies fail. 



DIARRHEA. 

LOOSENESS OR PURGING. 

Definition. — Frequent, excessive, fluid evacuations from 
the bowels, without tormina or straining, from functional or 
structural changes in the small intestines of a local or consti- 
tutional origin. 

Diarrhea really depends upon defective absorption by the 
intestines, so that more than a healthy proportion of matter 
passes through them, and less is taken up for the nourish- 
ment of the body. 

There are several forms of diarrhea. We have irritative 
diarrhea, from improper food and drink ; congestive or inflam- 
matory diarrhea, from cold, or drinking ice-water when the 
body is over-heated ; diarrhea lienterica, from indigestion ; 
and summer diarrhea. Thin watery stools is evidence that 
the cause is in the small intestines. 

It is unnecessary for me to go into a detail of the symp- 
toms of diarrhea, for they are of various grades, and the color 
of the stools is of all shades and consistency, as you will learn 
from the grand characteristics of the remedies called for. 



THEORY AND PRACTICE OF MEDICINE. 329 

Treatment. — I will mention only a few of the most 
prominent remedies. You have the whole materia medica to 
cull from. You must select your remedy in accordance with 
the color, consistency, odor, pain, if any, before and after 
stool. 

Aconite. — Stools frequent and scanty, watery, whitish, or 
slimy ; nausea and sweat before, and tenesmus during stool. 

Aloes. — Stools ; small, brownish, slimy, half fluid ; yellow, 
bloody, jelly-like mucus ; drives out of bed at 6 A. M. ; sensa- 
tion of a plug in the rectum. 

Apis. — Sensation in the abdomen as if something would 
break ; stools greenish, yellowish, slimy mucus, or yellowish 
watery. 

Argenhim nitricum. — Stools green, fetid mucus, passing 
off with much flatus. Nausea with loud eructations. 

Arsenicum. — Stools thick, dark-green mucus, or brown, 
black, watery. 

Belladonna. — Stools thin, green mucus, or white watery 
mucus, small and frequent ; sleepy but cannot sleep. 

Benzoic acid. — Stools watery or light-colored ; copious ; 
very offensive. 

Bryonia. — Stools brown, thin, fecal, or undigested, smell- 
ing like rotten cheese ; nausea when sitting up. 

Calcarea carb. — Stools whitish or watery ; chronic diar- 
rhea, with clay-like stools ; distended abdomen ; profuse sweat 
on head when sleeping ; feet cold and damp. 

ChamomUla. — Stools green, watery, corroding, with colic ; 
liked chopped eggs ; smelling like rotten eggs. 

Colocynth. — Stools saffron-yellow, frothy, or thin, slimy, 
and watery ; before stool cutting colic, great urging. 

Croton tiglium. — Yellow, watery, or greenish-yellow stools 
expelled with great force ; colic and writhing around the um- 
bilicus. 

Dulcamara. — Yellowish, greenish watery or whitish stools ; 
colic before and during stool ; if caused by cold damp weather. 

Gummigutti, or gambogia. — Stools yellow or green, mixed 



330 THEORY AND PRACTICE OF MEDICINE. 

with mucus ; very offensive ; loud gurgling as of water in the 
bowels ; rapid expulsion of the stool. 

Hellebores. — White, jelly-like mucus stools, with urging 
and tenesmus ; vomiting of green or blackish substances. 

Ipecac. — Stools grass-green mucus ; fermented ; vomiting 
of yellow, green, or jelly-like mucus ; flatulent colic. 

Iris. — Painful, green, watery stools, worse at night, about 
2 or 3 A. m. ; burning in the rectum ; vomiting of sour fluid, 
with burning in the mouth and fauces. 

Jatropha. — Profuse watery diarrhea, gushing out like a 
torrent ; noise as of a bottle of water emptied into abdomen. 

Leptandra. — Stools black, papescent, tar-like, very fetid. 

Mercurius. — Stools dark-green, slimy, frothy, or bloody; 
frequent urging and tenesmus, during and after stool ; violent 
thirst for cold drinks. 

Nux Moschata. — Stools thin, yellow, like stirred eggs ; 
before stool, cutting pain in the abdomen. 

Nux vomica. — Frequent small watery, slimy, brownish 
mucous stools ; colic and tenesmus before and during stool, 
with relief after. 

Oleander. — Stools thin, yellow, undigested, involuntary. 

Phosphorus. — Chronic ; painless diarrhea, worse in the 
morning; stools undigested, watery, with little white flakes 
or lumps like sago ; vomiting of what has been drunk as soon 
as it becomes warm in the stomach. 

Podophylhim. — Profuse watery stools, with meal-like sedi- 
ment ; also yellow mucous stools, smelling like carrion. Be- 
fore stool, loud gurgling in the bowels as of water ; during 
stool, prolapsus ani. 

Pulsatilla. — Stools greenish, yellowish, like bile ; very 
changeable stools ; before stool, rumbling and cutting pain in 
the bowels. 

Rheum. — Stools green, brown, fermented ; sour smelling 
diarrhea of children ; colic before and during stool, and tenes- 
mus after ; the whole body has a sour smell, which cannot 
be removed by washing. 



THEORY AND PRACTICE OF MEDICINE. 33 1 

Rhus tox. — Stools reddish or yellowish mucus ; cutting 
colic before and during stool, with relief after stool. 

Sulphur. — Stools, yellow, brown, green, undigested ; early 
morning diarrhea, without pain ; constant heat on top of the 
head. 

Thuja. — Copious, pale-yellow, watery stools, discharged 
with great force ; gurgling like water from a bung-hole in a 
barrel. 

Veratrum album. — Profuse, watery, blackish or greenish, 
stools ; severe pinching colic before and during stool ; after 
stool, weakness, cold sweat on the forehead. 



DYSENTERY. 

BLOODY FLUX. 

This disease is characterized by inflammation and ulcera- 
tion of the mucous coat and glands of the colon. The lower 
portion of the descending colon is the part usually involved ; 
but in epidemics the whole of the large intestines are often 
affected. 

Symptoms. — The disease is often ushered in with 
rigors, followed by hot dry skin, quick pulse, thirst, often pain 
in the head. The patient complains of griping pains in the 
abdomen and tenesmus. 

The stools at first may contain some fecal matter, but 
soon the stools become scant and bloody ; or bloody mucus. 
Sometimes there is pure mucus, either white or yellowish ; 
and then again there is mucus tinged with blood, resembling 
the scrapings of the intestines. The tenesmus is often great, 
and the motions so frequent that the patient can get scarcely 
any rest. In some forms of epidemics, the disease assumes a 
low typhoid condition ; the stools are dark, bloody and offen- 
sive ; the pulse becomes weak and feeble. In mild sporadic 
cases there is but little or no fever, and the patient soon re- 
covers his usual health,.. ; ,..;,, , 



332 THEORY AND PRACTICE OF MEDICINE. 

Pathology. — The mucous coat of the colon is often 
sloughed off ; ulceration and gangrene of a part, and often a 
considerable portion of the large intestine is observed. 

Causes. — A high temperature, an epidemic influence, 
exposure to wet and cold. 

Diagnosis. — Bloody mucous discharges with tenesmus. 

Prognosis. — There is little or no danger from mild 
sporadic cases. But in certain epidemics it often proves a 
most fatal disease. 

Unfavorable. — Violent and distressing tenesmus, vomit- 
ing, hiccough, delirium, tongue dry and red, involuntary fetid 
evacuations, the limbs cold, pulse intermittent, and pain ceas- 
ing suddenly. 

Favorable. — The stools becoming yellow and less fre- 
quent, an abatement of tenesmus and fever. 

Treatment. — I have had such uniform success with 
aconite and mercurius cor., that I always prescribe them at the 
beginning of an attack. They are both homoeopathic. 

It is supposed that in dysentery of warm climates, and in 
malarious districts, that gelsemium acts better than aconite. 
You must however be governed by the symptoms in each case. 

Mercurius cor. — Stools pure blood, or bloody mucus ; dur- 
ing stool, painful pressing, straining, and tenesmus ; almost 
constant cutting pain in the abdomen, mostly around the 
umbilicus ; great tenesmus of the bladder, with scanty secre- 
tion of urine. 

If aconite and mercurius cor. does not cure in a reasonable 
time, or if other symptoms are present, or are developed, then 
you must resort to some one of the following remedies as they 
seem to be indicated. 

Aloes. — Stools bloody, jelly-like mucus, or bloody water ; 
violent tenesmus, especially in the lower rectum. 

Arsenicum. — Stools dark or blackish fluid, mixed with 
blood of a putrid foul smell, involuntary ; during stool, tenes- 
mus and burning in the rectum ; great anguish and fear of 
death ; extreme thirst, drinks often but little. 



THEORY AND PRACTICE OF MEDICINE. 333 

Baptisia. — Stools scant, bloody mucus ; pain before and 
during stool ; soreness of the flesh and whole body, with chilli- 
ness ; the sweat, urine and stools, are all extremely fetid. 

Belladonna. — Stools greenish, slimy, bloody ; great tenes- 
mus during and after stool ; mouth and throat very dry, with 
little or no thirst ; sudden starting and jumping during sleep. 

Bryonia. — Thin, bloody stools, preceded by cutting colic ; 
patient wants to keep quiet, any movement causes nausea ; 
he wants large draughts of water at long intervals. 

Cantharis. — Stools white, or pale-reddish, like scrapings of 
the intestines ; great tenesmus and burning, stinging in the 
rectum ; frequent urging to urinate, with slight and painful 
discharges. 

Colocynth. — Stools bloody mucus, or like scrapings ; be- 
fore stool, cutting pain and great urging ; relief after every 
evacuation. 

Ipecac. — Stools bloody, or bloody mucus ; much nausea 
and vomiting. 

Rhus tox. — Reddish mucus, or jelly-like stools ; colic with 
pain running in streaks down the limbs, with every evacua- 
tion ; remission of pain after stool, and from moving about 

MALIGNA. 

HEMORRHAGE FROM THE BOWELS. 

The blood is supposed to flow from the vessels of the in- 
testines in consequence of obstruction of the flow of the vena 
portse distributed to the liver. It is rarely attended by any 
morbid changes in the mucous membrane of the intestines. 

Diagnosis. — From hemorrhoids by the absence of sore^ 
ness and tenesmus, and generally by the more abundant flow 
of blood. 

Treatment. — Arnica. — Hemorrhage from the bowels 
after mechanical injury. 

Hamamelis virginica. — Dark blood. If the hemorrhage 
is alarming, two drachms of the mother tincture mixed in an 



334 THEORY AND PRACTICE OF MEDICINE. 

ounce of cold water, may be thrown into the rectum by a 
syringe. 

Terebinthina. — This is an invaluable remedy for hemor- 
rhage from the bowels. 

Veratrum viride. — This remedy is supposed to act bene- 
ficially in hemorrhage from the bowels. 



TORPOR INTESTINORUM. 

CONSTIPATION OR CONFINED BOWELS. 

When in their normal condition the bowels perform their 
function once in twenty-four hours ; but when that condition 
supervenes, called constipation, then they only move once in 
two, four, and sometimes only once in seven days. The pri- 
mary cause of impaction of feces in the rectum, is due to 
paralysis of the muscular coats of the intestines, by which 
their peristaltic movement is arrested ; and hence there being 
no force to expel their contents, impaction or constipation is 
the inevitable result. The worm-like movement, or func- 
tional activity of the intestines, is often arrested by over stim- 
ulation. Thus drastic purgatives stimulate the muscular 
coats of the intestines to violent activity, and hence the sec- 
ondary effect will be exhaustion, and loss of the spiral motion 
of the intestines, and constipation will result. It is supposed 
that bile from the gall-bladder furnishes the proper stimuli 
to the normal peristaltic movements of the intestines. That 
being true, then torpor of the liver may cause constipation by 
the withdrawal of the normal stimulus, to the coats of the in- 
testines. Sedentary habit may produce constipation. I am 
now speaking of simple torpor of the bowels, which medi- 
cines may overcome. There may be obstruction of the 
bowels from hemorrhoids, or internal tumors, which require 
special treatment before constipation can be overcome. It is 
unnecessary for me to go into a detailed account of the symp- 
toms of constipation, as the remedies which I will mention 



THEORY AND PRACTICE OF MEDICINE. 335 

will explain the character and symptoms of each variety of 
torpidity of the bowels. 

Treatment. — Agaricus. — Stools very hard, knotty, and 
scant ; much pressing and straining to pass even a soft stool. 

Apis. — Tenderness of the abdomen to pressure ; sensation 
in the abdomen as if something would break if much effort 
was made to void the stool. 

Bryonia — Headache as if the skull would split ; worse from 
motion ; hard, dry stools as if burnt. 

Calcarea carb. — Stools large, hard, and sometimes only par- 
tially digested ; cold damp feet. 

Cctiisticnm. — Stools tough, light-colored, whitish, shining 
like grease ; soft stools, size of goose-quill. 

Chelidonium. — Constant pain under the lower inner angle 
of the right shoulder-blade ; stools like small hard black balls. 

Graphites. — Stools hard and knotty, the lumps being united 
by mucus threads ; some times large quantities of mucus are 
expelled with the stool. 

Kali carb. — Inactivity of the rectum ; the stool is too large, 
and there is a sensation as if rectum were too weak to expel it. 

Lycopodium. — Stools very hard, scant, and passed with 
great difficulty ; loud rumbling and gurgling in the bowels ; 
red sand in the urine. 

Nux vomica. — Stools large, hard, and passed with great 
difficulty ; frequent urging to stool. 

Opium. — Costiveness for weeks, with loss of appetite ; 
stools of nothing but small, hard black balls ; 30th potency 
the best to relieve. 

Phosphorus. — Stools long, slender, hard ; difficult to expel. 

Plumbum metallicum. — Constipation with violent colic ; 
stools composed of little hard black-brown balls ; a sense of 
constriction in the sphincter ani, with ineffectual urging ; 30th 
potency. 

Sulphur. — Stools hard and lumpy, mixed with mucus, fol- 
lowed by burning pain in the rectum ; first effort at stool is 
often very painful ; constant heat on top of the head. 



336 THEORY AND PRACTICE OF MEDICINE. 

Thuja. — Violent pain in the rectum during stool ; dis- 
charge of large, hard, brown feces, in balls, streaked with 
blood. 

Zincum Metallicum. — Constipation, with hard, dry, insuffi- 
cient stool, with much straining, and rumbling in the bowels ; 
chronic sick headache, and great weakness of sight. 

If constipation is due to mechanical obstruction, then sur- 
gical appliances must be resorted to. If there be impacted 
feces, and symptoms require immediate action, then you should 
give an enema of a quart to half a gallon of warm water, as 
warm as the patient can stand. A diet of fruits, coarse bread, 
and regular exercise, and a glass of cold water before breakfast 
assist in regulating the bowels. The bowels can be trained 
to regular habits at any hour of the day, and that habit should 
never be interrupted on any account. 



COLICA— COLIC. 

SPASMS OF THE BOWELS. 

Symptoms. — Severe pain in the abdomen, retraction of 
the umbilicus, with a peculiar sense of twisting, occurring in 
paroxysms, and relieved by pressure ; obstinate costiveness ; 
flatulence ; nausea and vomiting ; with a pulse little increased 
in frequency. 

Diagnosis. — The two conditions that may give you 
trouble, unless you are on your guard, are enteritis and hernia. 
Colic has violent paroxysms of pain, which is partly relieved 
by pressure, and there are periods of intermission from pain ; 
and but little or no fever. Enteritis has fever, with extreme 
tenderness of the abdomen, especially on pressure. You should 
inspect every case of abdominal trouble carefully ; if the pain 
or colic is caused by hernia, then you will discover a swelling 
or tumor-like projection at the right or left inguinal rings. 

Causes. — Colic is usually the result of errors in diet, in- 
digestible food, nuts, fruit ; cold from getting wet. 



THEORY AND PRACTICE OF MEDICINE. 2)Z7 

Treatment. — If the patient is suffering with intense 
pain, then you should give a warm water enema at once fol- 
lowed with the indicated remedy. If the enema does not give 
relief, then cover the abdomen with flannel cloths wrung out 
in hot water. 

Aconite. — Pains in abdomen so violent that he screams, 
and tosses about. 

Belladomia. — Spasmodic colic ; constriction of the abdo- 
men around the umbilicus, as if a ball would form. 

Chamomilla. — Flatulent colic, the abdomen being dis- 
tended ; pressing towards the abdominal ring, as if a hernia 
would protrude ; chamomilla is the grand baby remedy for 
colic. 

Colocynth. — Violent cutting pains ; intestines feel like 
being squeezed by hard substances, compelling one to bend 
double. 

Cuprum metallicum. — Violent spasms in the abdomen and 
in upper and lower limbs, by spells ; fearful cries as if he were 
being killed. 

Iris versicolor. — Obstinate cases with flatulence. 

Collinsonia. — Colic with flatulence and spasm of the bowels. 

Dioscorea villosa. — Bilious colic, sudden attacks of vomit- 
ing bilious matter. 

Nux vomica. — Pressure in the stomach as from a stone ; 
flatulent colic ; frequent urging to stool without effect. 

Plumbum. — Violent colic, with sunken abdomen ; constric- 
tion of the intestines, the navel being violently drawn in ; 
obstinate constipation with dark small balls. 

Veratrum album. — Terrible colic, with violent nausea and 
vomiting ; cold sweat over the whole body. 

There are times when the patient is in such pain as to 
incapacitate him from giving his symptoms ; in that case, if 
colocynth, collinsonia or cha7nomilla ) do not give relief, then 
rather than run the risk of having a hypodermic physician 
sent for you may give from ten to twenty drops of chloroform 
in a little syrup of acacia at one dose. That will usually 



338 THEORY AND PRACTICE OF MEDICINE. 

quiet your patient, and give you time to gain a knowledge of 
the correct symptoms so as to enable you to make a judicious 
selection of the indicated remedy. 

COLICA PICTONUM. 

LEAD COLIC — PAINTERS' COLIC. 

Symptoms. — This disease resembles somewhat simple 
colic. It comes on more gradually, and the patient often 
complains of pains in the limbs, or of weakness. Partial 
paralysis is of frequent occurrence. It frequently manifests 
itself by what has been termed drop-wrist. 

Causes. — The inhalation of lead by workers in lead 
works, and by house painters. 

Diagnosis. — The history of the case and the occupa- 
tion of the patient will assist you in arriving at a correct con- 
clusion. If still in doubt, then examine the mouth, and you 
will usually find a blue line on the gums near the margin of 
the teeth, which is diagnostic of lead poisoning. 

Treatment. — Alumina. — Flatulent colic ; painters' 
colic. 

Opium. — Colic from lead. 

Platina. — Pain in umbilical region, extending through 
into back ; patient screams and tries to relieve the pain by 
turning into all possible positions 

Podophyllum. — Cramp-like pain in bowels, with retrac- 
tion of abdominal muscles. 

Zincum. — Flatulent colic ; loud rumbling and rolling ; re- 
traction of abdomen. 

Sometimes persons working in lead often eat their lunch 
without washing their hands ; and then again water, is often 
drunk from vessels containing lead. Therefore, when you find 
more lead in the system than can be overcome by homoeo- 
pathic potencies ; then it is your duty to resort to antidotes. 
I presume that no one claims that potentized medicines can 
overcome the effects of poisonous drugs. 



THEORY AND PRACTICE OF MEDICINE. $2>9 

Iodide of potash in one to two grains three or four times 
per day, or every hour, where the symptoms are urgent, will 
convert the lead into the iodide of lead, which is harmless, and 
hence it is carried out of the system through the kidneys. 
After this a few doses of nux vomica will relieve all pain and 
weakness of the abdomen. 



TYMPANITIS. 

DRUM-ABDOMEN. 

Symptoms, — This disease may be sudden or slow in its 
development. It is attended by flatulency and colic ; the 
abdomen is often enormously distended ; and the bowels are 
costive. The air is almost always contained in the stomach 
and intestines. It is usually found in the arch and sigmoid 
flexure of the colon. 

Causes. — Errors in diet, or anything that will cause the 
formation of gas in the stomach and bowels. Excessive use of 
purgatives and alcoholic liquors. 

Diagnosis. — Tympanitis gives a clear sound on percus- 
sion ; while ascites gives dullness on percussion with fluctu- 
ation. 

Prognosis. — Is almost always favorable unless tym- 
panitis is due to the escape of air into the peritoneal sack, in 
consequence of ulceration of the bowels in typhoid fever. In 
that case it is almost always fatal. 

Treatment. — Car bo veg. — Colic from flatulence, abdo- 
men full to bursting. 

Chamomilla. — Wind colic, abdomen distended like a drum,, 
wind passes in small quantities without relief ; abdomen tym- 
panitic and sensitive to touch. 

China or cinchona. — Tympanitic abdomen, pressure as 
from a hard body, or spasmodic, constrictive pains from incar- 
cerated flatulence. 

Colocynth. — Abdomen distended and painful ; tympanitic ; 
incarcerated flatus. 



340 THEORY AND PRACTICE OF MEDICINE. 

Hyoscyamns niger. — Colic, as if abdomen would hurst ; 
abdomen distended, sore to touch, tympanitic. 

Lycopodinm. — Accumulation of flatulence, which becomes 
incarcerated ; pressing upward, also downward on the rectum 
and bladder. 

Nux vomica. — Flatulence, colic, with pressure upward, 
causing dyspnoea, and downward, causing urging to stool and 
urination. 

At the same time that you are administering your remedy 
you can give an enema of water as warm as the patient can 
stand. 



HEMORRHOIDS. 

PILES. 

One or more small tumors are often found surrounding 
the external opening of the rectum, which are called piles. 
They may be single, or appear in clusters like a bunch of 
grapes, and are called external piles. Those within the rec- 
tum are denominated internal piles. 

They are of various sizes and texture. Internal piles are 
semi-solid and covered with mucous membrane. External 
piles are usually tough and covered by true skin. Internal 
piles often protrude, hence they are called protruding piles. 
If they do not protrude they are called blind or bleeding piles. 

Symptoms. — Piles are the result of congestion and 
nodulation of the hemorrhoidal veins, which become tender 
and often very painful. There is often heat and burning in 
the rectum, the parts are swollen and tender. By reflex action 
piles may simulate a diseased condition of the various organs 
of the pelvis. Hence it is that many patients are treated for 
inflammation or neuralgia of the ovaries, when the symptoms 
are only reflex from piles. 

Causes. — The causes of piles are constipation, sedentary 
life, and abuse of aloes and other purgative medicines. 



THEORY AND PRACTICE OF MEDICINE. 341 

Treatment. — My experience has been that piles are 
curable by medicines without use of the knife, if treated early 
before they become too hard. 

Aconite is called for if the patient is feverish, and the 
piles are hot and painful. 

sEscuhis is a valuable remedy for bleeding piles, with pain 
in the rectum, and pulsations resembling the beating of little 
hammers. 

If the piles are swollen and tender, with stinging pain, 
apis is a valuable remedy 

Aloes is the remedy par excellence for painful protruding 
piles ; 30X is the best. 

Arsenicum is indicated w 7 hen the piles are riot and burn- 
ing, with severe pain in the back. 

Collinsonia is beneficial for blind or bleeding piles, with 
a sensation as if a gravel or sand had lodged in the rectum ; 
obstinate constipation. 

Hamamelis will overcome a varicose condition of the 
hemorrhoidal veins, and arrest bleeding. If the hemorrhage 
is great then half a drachm or more of the tincture may be 
mixed in two tablespoonfuls of cold water, and thrown into 
the bowels and repeated if necessary. 

Ignatia has violent shooting pains high up in the rectum ; 
the tumors prolapse with every stool and have to be replaced. 

Nux vomica is called for when piles are associated with, 
constipation, with burning, pricking pains in the tumors. 

Sulphur is indicated for blind or bleeding piles, with con- 
stant urging to stool, which continues after a thin bloody 
evacuation ; stinging, burning, and soreness in and around the 
anus ; prolapsus recti. 

As I have said before I think that internal homoeopathic 
remedies can cure without external applications, and yet I can 
see no impropriety in using them when the patient is suffer- 
ing intensely and the friends are anxious and impatient. I 
yield the palm to no one in my devotion to similia. and yet 
we must use judgment in the treatment of our patients. 



342 THEORY AND PRACTICE OF MEDICINE. 

The warm water douche to the colon from one to three 

times per week is very advantageous in many cases, while in 

others it may aggravate when used too often. It is, however, 

beneficial in all cases of constipation. The intense pain is 

often relieved either by cold or warm applications. 

I have witnessed fine results from an ointment composed 
of an ounce of vaseline and twenty drops of tincture of cesculus. 
If the piles are very tender and painful, quick relief may be 
had by adding five grains of muriate of cocaine to the ointment. 
I wish to say, however, that a large majority of the cases may 
be cured without any external applications. 

PURITIS ANI. 

ITCHING OF THE ANUS. 

This is sometimes a most annoying trouble to the patient. 
It often prevents sleep, and the patient often makes the parts 
raw from scratching. 

Treatment. — When immediate relief is demanded I 
usually apply a mixture of ten drops of carbolic acid to an 
ounce of olive oil. Sometimes the flour of sulphur applied to 
the parts gives immediate relief. We must look for the cause 
before we can select our curative agent. If thread-worms 
are the cause then cina and ignatia are almost specific. 

Sulphur is indicated for itching and burning of the anus. 

When cina and ignatia have failed to prevent the develop- 
ment of thread-worms, I have been able to destroy the larva 
and prevent their return by injecting the bowels each night, 
for two or three nights, with a mixture of half a teaspoonful 
of the juice of bruised garlic to two tablespoonfuls of water. 
I have never known it fail to destroy the nest. 

PROLAPSUS ANI. 

This is a protrusion of the mucous membrane during stool 
and resembles in shape a full-blown rose. It is usually free 



THEORY AND PRACTICE OF MEDICINE. 343 

from pain or tenderness, but sometimes it may be quite sore 
and painful. 

Treatment. — The prolapse should be returned after 
each stool. The finger must be lubricated and gentle pres- 
sure made upon the protruded part until finger and prolapse 
pass beyond the sphincter. 

Ignatia. — This remedy is said to be almost specific. It is 
indicated for frequent ineffectual urging to stool, straining, 
difficult passage of feces. 

Nux vojnica. — Is used for costiveness, straining at stool, 
with prolapsus. 

Podophyllum. — Diarrhea with straining and offensive stools 
with prolapsus. 

Arsenicum, bryonia, calcai r ea carb., gamboge, lycopodium, 
sepia and sulphur, are indicated in some cfases. 

When prolapsus becomes chronic, then it becomes diffi- 
cult to keep it in place, and a surgical operation becomes 
necessary. 

BILIARY SYSTEM. 

Icterus Jaundice. 

Hepatitis Inflammation of the Liver. 

Biliary Concretions Gall stones. 

Pancreatitis Inflammation of the Pancreas. 

ICTERUS— JAUNDICE. 

Symptoms. — The patient feels languid and feverish. 
There is an icteric hue both of the skin and conjunctiva. The 
color is almost as yellow as gold. It extends to the whole 
body. There is an uneasy feeling in the stomach, often pain 
in the epigastric region. The urine is a deep yellowish or 
brownish color; the feces are whitish, and constipation is 
present. The brain often becomes involved, and the patient 
has symptoms resembling those of delirium tremens. The 
yellowness of the skin is often of long standing in chronic 



344 THEORY AND PRACTICE OF MEDICINE. 

jaundice ; but the early application of homoeopathic treatment 
will usually restore the skin to its normal color in a short 
time. 

Causes. — Inflammation, or pressure from whatever cause, 
of the ductus communis choledochus will produce jaundice. 
Also spasm of the duct from mental excitement, or its closure 
by biliary calculi, will prevent the flow of bile to the duode- 
num ; and hence, having no outlet, it is reabsorbed and car- 
ried through the circulation, and stains even' tissue through 
w T hich it passes. Nature, in trying to get rid of the effete 
material forces it to the surface, with the hope of throwing it 
out of the system through the cutaneous pores. In this effort 
those emunctories are clogged with inspissated bile, and hence 
the yellowness of the skin. 

Diagnosis. — The yellow skin and icteric hue of the con- 
junctiva ; the bitter taste in the mouth ; the yellow tinge com- 
municated to linen by the urine, the clay-colored feces, leave 
no room to doubt as to the character of the disease. If you 
want to demonstrate the fact whether there is bile in the urine 
or not, all you have to do is to add a little nitric acid to the 
suspected urine, and if bile is present a deep green color will 
appear. The question is easily answered as to whether a cer- 
tain case is jaundice, or not ; but the puzzle will be what 
caused it ; for the success of your treatment will depend in a 
measure as to the cause. 

Prognosis. — Simple jaundice is easily cured, but if can- 
cer of the liver is the cause then there is no hope. If the dis- 
ease assumes a low typhoid condition then the case is very 
grave. 

Treatment. — Acute Jaundice. — Aconite. — Yellowish 
color of the skin ; scanty urine ; fever and pain in region of 
the liver. 

Chamomilla. — Yellow face ; green, watery, corroding stools, 
with colic, and bilious vomiting ; children want to be carried, 
fretful when they are laid down. 



THEORY AND PRACTICE OF MEDICINE. 345 

Mercuritis. — Complete jaundice, with painfulness in the 
region of the liver ; skin very yellow ; grayish-white feces, 
with tenesmus during and after stool ; nausea and vomiting. 

Nux vomica. — Swelling and hardness of the liver ; sour 
or putrid taste, with aversion to food ; nausea and bilious 
vomiting ; cannot sleep after 3 a. m. 

Bryonia. — Yellow skin of the whole body, even of the face. 

Chronic Jaundice. — I need not repeat the remedies al- 
ready given for acute jaundice, for they are also beneficial in 
the chronic. 

Chelidoniiim ??iajis. — Yellowness of the skin, with pain or 
tenderness in the liver, and under the inner angle of the right 
shoulder-blade. 

Arsenicum. — Yellowness of the skin and sclerotica ; great 
anguish, restlessness, and fear of death ; urgent thirst, drinks 
often but little. 

China. — If jaundice is accompanied with the passage of 
biliary calulus through the gall-duct, then china is a valu- 
able remedy. 

Digitalis. — Soreness and bloatedness of the pit of the 
stomach ; stools almost white ; frequent and painful emis- 
sions of scanty, brown urine ; also, irregular or intermittent 
pulse. 

Iodine. — Yellow, almost dark-brown color of the face ; 
white diarrhetic stools, alternating with constipation ; dark 
yellowish-green, corroding urine. 

Leptandra. — Dull aching in the region of the gall-bladder ; 
chilliness along the spine ; constant distress between the um- 
bilicus and epigastrium ; clay-colored or black, fecal fluid 
stools. 

Podophyllum. — Pain in the region of the gall-bladder, at- 
tended with excessive nausea ; fullness and soreness in the 
liver. 

Phosphorus. — Brownish-yellow skin and conjunctiva ; fre- 
quent, copious, whitish-gray evacuation ; blackish-brown urine ; 



346 THEORY AND PRACTICE OF MEDICINE. 

dejection and despondency ; sometimes loss of voice, cough, 
and other symptoms of malignant jaundice. 

I should have said that arsenicum is indicated in malig- 
nant jaundice, with a low typhoid condition, with dark and 
cold skin. 

HEPATITIS. 

INFLAMMATION OF THE LIVER. 

Inflammation of the liver may be acute or chronic, but the 
symptoms are similar, only there is but little fever in the 
chronic form. 

Symptoms. — Pain in the right hypochondrium, in- 
creased by pressure, by deep inspiration, by coughing ; diffi- 
culty of breathing ; shooting pains in the chest, resembling 
pleurisy ; sympathetic pain in the right shoulder ; a yellow 
tinge of the tunica conjunctiva, and sometimes actual jaun- 
dice ; high-colored urine ; costiveness or diarrhea. When the 
concave surface of the liver is affected, the pain is more ob- 
scure, and is referred to the back ; the breathing is less anx- 
ious, the functions of the stomach more disordered, producing 
vomiting, hiccough, and other symptoms of gastritis. When 
the left lobe of the liver adjacent to the stomach is inflamed, 
there is nausea and vomiting, and when the posterior and in- 
ferior portion of the organ near the kidney is implicated, there 
is more or less pain or disturbance in the function of the last 
mentioned organ. 

Terminations. — In resolution j in chronic disease ; in 
abscess ; in gangrene. 

Abscess of the liver may burst into the stomach, and be 
emptied by vomiting; into the colon or duodenum, and be 
evacuated by the bowels ; through the diaphragm into the cav- 
ity of the chest, and form empyema ; into the luUg or bron- 
chial tube, and be expectorated. The nature of the disease 
will be inferred from the color of the discharged matter, and 
from the rigors, throbbing pain, and hectic fever attending 
the process of suppuration. 



THEORY AND PRACTICE OF MEDICINE. 347 

Causes. — Whatever will cause inflammation in other 
parts of the body, may produce it in the liver. External vio- 
lence, powerful emesis, intense solar heat, and the intemper- 
ate use of spirituous liquors. 

Diagnosis. — By pain and swollen condition of the liver 
by pressure. It sometimes simulates pneumonia ; but in this 
disease the pain is in the middle lobe of the lung, while in 
hepatitis the pain is felt in the shoulder. The cough in hepa- 
titis is unaccompanied by expectoration. 

Prognosis. — Favorable. — A copious perspiration, and 
bilious diarrhea, and copious sediment in the urine. 

Unfavorable. — Pain and fever intense, pain confined to 
one spot ; obstinate constipation ; cold extremities, and hic- 
cough. 

Treatment. — Aconite. — For fever and inflammation 
first stage. 

Arsenicum. — Region of the liver tender and swollen, with 
violent burning pains ; vomiting of brownish or blackish sub- 
stances ; diarrhea of blackish stools, worse after eating or 
drinking ; violent thirst, drinking little and often ; rapid pros- 
tration of strength. 

Bryonia. — Burning or stitching pains in the hypochon- 
dria ; pain in the right shoulder and arm ; bitter taste in the 
mouth, with bilious vomiting ; want to keep perfectly quiet. 

Chelidonium. — Pain and tenderness of the region of the 
liver ; icteric hue of the skin ; pain under the right shoulder 
blade. 

Hepar sulphur. — This is a valuable agent to prevent ab- 
scess in the liver. Whenever the symptoms do not yield 
readily to your remedies, and you fear the formation of an 
abscess, then you should give the 30th potency of hepar sul- 
phur, and in this way you may ward off an abscess of the liver. 

Leptandra virginica. — Black, profuse, papescent, tar-like, 
very fetid stools ; constant dull pain in region of gall-bladder. 

Silicea. — Hardness and distention of the region of the liver ; 
throbbing, ulcerative pain, increased by contact and motion ; 



348 THEORY AND PRACTICE OF MEDICINE. 

formation of abscesses ; lymphatic swellings, with inclination 
to suppurate. 

Sulphur. — Chronic hepatitis ; swelling and hardness of the 
liver ; constant heat on top of head ; drowsy during the day, 
wakeful the whole night. 

When you are sure that there is an abscess on the liver, 
then you should aspirate before it breaks. You must, how- 
ever, familiarize yourself well with the anatomy of the parts, 
and make a correct diagnosis of the location of the abscess. 

QALL=STONES. 

This is a hardened calculus formed in the liver by the 
crystallization of the constituents of bile. Their presence is 
made known by pain in the region of the gall-duct. 

Treatment. — During the passage of a gall-stone the 
pain is sometimes excruciating, then aconite is a valuable 
agent. If aconite does not give relief, and the patient and 
friends become impatient, you can saturate a small cloth with 
chloroform, and place over the seat of pain, the cloth must be 
covered with paper to prevent evaporation of the chloroform. 
This often gives instantaneous relief. You can give your 
remedies between the paroxysms, and when they return re- 
apply the chloroform. As soon as it begins to burn and pain is 
relieved, then remove the chloroforin or else it will blister. 
By this means the parts are relaxed, and thus the duct is en- 
larged so as to permit the calculus to pass. 

It is said by some writers that berberis and chelidonium 
majus low have expelled gall-stones and prevented their ac- 
cumulation. 

It is said that china is able to dissolve gall-stones. and pre- 
vent their formation. 

I have removed biliary calculus by giving two ounces of 
olive oil, three times a day for two or three days, or if the oil 
acted on the bowels sooner, then discontinue its use. The 
philosophy of the treatment is this, the oil coming in contact 



THEORY AND PRACTICE OF MEDICINE. 349 

with the calculus through the circulation, is absorbed by 
them. After the oil penetrates the gall-stones, they are soft- 
ened and are readily passed through the duct. I presume 
that after a certain amount of oil has been taken, or more than 
can be taken up by the lacteals at once, the remainder causes 
catharsis, and hence a powerful peristaltic movement being 
set up, and hence a vacuum of the duodenum causes a suction 
in the gall-duct, and hence the softened and lubricated gall- 
stones readily pass into the bowel. 

If water is mixed with the fecal matter the gall-stones 
will float, and will be seen about the size and color of small 
hazlenuts. 



PANCREATITIS. 

INFLAMMATION OF THE PANCREAS. 

This -is a disease that is very obscure, and on that account 
but few writers ever mention it. It is characterized by a deep- 
seated pain in the epigastrium. It occasions nausea, sickness, 
and emaciation. Constipation or diarrhea, jaundice, and sali- 
vation are usually present. 

Diagnosis. — This is obscure because the stomach and 
pancreas are in such close proximity that it is often difficult 
to make a correct diagnosis. But where there is emaciation, 
from imperfect assimilation, then you may know that there is 
a deficiency of pancreatic fluid ; and the dull pain in the back, 
opposite the pancreas, calls your attention to them as the seat 
of the pathological change going on. 

Treatment.— Iodine. — Indigestion and emaciation, diar- 
rhetic stools, and wasting — the food not being assimilated — 
indicates disease of the pancreas. 

Iris versicolor. — Inflammation of the pancreas, with burn- 
ing distress ; and sweetish vomiting. 

Mercurius. — Fullness in the left hypochondrium, with 
burning pain and tenderness in the region of the pancreas. 



350 THEORY AND PRACTICE OF MEDICINE. 

I neglected to say that when there is a want of assimilation 
and emaciation thereby, not directly traceable to disease of the 
pancreas, then the trouble is in the mucous coats or the villi 
of the bowels. 



SECRETORY SYSTEM. 

Under this head we will only mention the different forms 
of dropsy. I may remark here that dropsy is not a disease 
proper ; but is the evidence or result of disease or obstruction 
to the circulation. 

Anasarca Dropsy of the Cellular Tissue. 

Ascitis Dropsy in the Abdomen. 

Hydrocephalus Dropsy of the Brain. 

Hydrothorax Dropsy of the Chest. 

Hydropericardium Dropsy of the Heart. 

Hydrops Articuli Dropsy of the Joints. 

Hydrosarca Spina Bifida. 

Hydrocele Dropsy of the Scrotum. 

GENERAL DROPSY, 

ANASARCA. 

Anasarca means dropsy of the cellular tissue. Hydrosarca 
is denned to be general dropsy of the flesh, and as both have 
reference to water in the cellular tissue they may be used 
synonymously ; I have, however, placed hydrosarca in the list, 
as water in the spinal column, which communicates with an 
external watery tumor through an opening in the vertebrae. 
This tumor was called hydrosarca, or spina bifida, by the old 
writers. It is congenital. 

Symptoms. — The first evidence we have of the ap- 
proach of dropsy is a little pufnness around the ankles ; after 
some little time the feet and limbs begin to swell. By pres- 
sure there is an indentation left, which is slow about regaining 
its rounded appearance. The swelling continues to spread, 



THEORY AND PRACTICE OF MEDICINE. 35 1 

until the whole body becomes edematous. The urine is scanty 
and highly colored ; the skin is pale and dry, and after the 
tissues become distended, water often oozes through the pores 
of the cuticle. 

Causes. — Any and everything that obstructs a free and 
easy circulation of the blood. Organic disease of the liver, 
heart, lungs and kidneys. General anaemia is a fruitful source 
of dropsy. 

Diagnosis. — Dropsy is distinguished from emphysema, 
by the swelling in anasarca pitting on pressure; in emphy- 
sema being elastic, and accompanied with crepitus. 

Prognosis. — Is favorable when the cause is amenable 
to treatment, otherwise it is a fatal symptom. 

Treatment. — Apis, — Dropsical effusion, with waxy 
paleness of the skin ; great soreness in the abdominal walls ; 
stinging, burning pains in different parts of the body ; must 
sit straight up to get any ease ; urine scanty, dark, like 
coffee-grounds. 

Apocynum. — Sinking feeling at the pit of the stomach ; 
irritable condition of the stomach ; obliged to sit up ; lying 
down produces violent dyspnoea ; urine very scanty, thick, 
yellow, and turbid. 

Arsenicum. — The skin looks pale, greenish, or livid ; ex- 
tremities swollen ; faint feeling from slightest motion ; suffo- 
cative spells, especially at night. 

Bryonia. — Lower eyelids edematous ; lips bluish, dry and 
cracked ; stitching pains in the region of the heart ; wants to 
lie perfectly quiet ; great thirst, and scanty urine. 

Digitalis. — Paleness of the face, blue lips, and swelling of 
the eyelids. 

Senega. — Dropsy as a sequala of albuminuria, or symptom- 
atic disorder of the liver, peritonitis, or abdominal tumors. 

These remedies are usually all that are needed to cure 
general dropsy in all curable cases. In addition to these 
remedies, you must select those that are indicated for organic 
diseases that caused the dropsy. 



352 THEORY AND PRACTICE OF MEDICINE. 

ASCITES. 

DROPSY OF THE ABDOMEN. 

Symptoms. — A gradual increase in the size of the ab- 
domen. It usually follows some organic disease ; in that case 
you have in addition to the swelling of the abdomen, symp- 
toms which usually accompany those diseases. When the 
abdomen becomes considerably enlarged you have dullness 
on percussion, and succussion. By placing your hands flat on 
the sides of the abdomen and give a quick to and fro motion, 
if there is water you will hear a splashing sound. As the ab- 
domen increases in size, the urine becomes scanty, bowels 
costive, and there is difficulty of breathing. If ascites con- 
tinues long, it is soon complicated with anasarca or general 
dropsy. 

Causes. — All organic diseases that obstruct the general 
circulation are causes of ascites. 

Diagnosis. — From all other causes of enlargement of 
the abdomen by the uniform infiltration ; dullness on percus- 
sion, and splashing sound heard by succussion. Encysted 
dropsy is local ; tympanites has clearness on percussion. 

Prognosis. — Favorable if there are no incurable or- 
ganic diseases. 

Unfavorable where there are incurable organic diseases ; 
great emaciation ; coma ; an impaired constitution. 

Treatment. — Apis. — Urine scanty, dark, like coffee- 
grounds ; complication with scarlet fever or uterine tumors. 

Apocynum cannabinnm. — Bruised feeling of the abdomen ; 
irritable condition of the stomach ; obliged to sit up ; lying 
down produces violent dyspnoea; urine very scanty, thick, 
yellow, and turbid ; after scarlatina. 

Arsenicum. — Dropsical swelling of the abdomen ; great 
debility and prostration ; dropsy after scarlatina, and when 
complicated with heart disease. 

Asparagus. — Is recommended as a food in dropsies ; the 



THEORY AND PRACTICE OF MEDICINE. 353 

potencies are given for scanty, straw-colored, and offensive 
nrine. 

China. — Organic affections of liver and spleen, and gen- 
eral debility. 

Convallaria. — Abdomen filled with water ; urine almost 
entirely suppressed ; weakness with a good appetite. 

Helleborus. — Cramp-like pains in the abdomen ; frequent 
desire to urinate, with scanty emissions ; after standing the 
urine looks like coffee-grounds ; after scarlet and intermittent 
fevers. 

Kali carbonicum. — Dropsy, especially of old people ; in 
complication with liver and heart disease. 

Lachesis. — Dropsies complicated with liver, heart, and 
spleen diseases ; urine black and scanty. 

Lycopodium. — Upper portion of the body emaciated, while 
the lower is greatly swollen; one foot cold, the other hot; 
urine scant, with red sediment, like sand ; after abuse of alco- 
holic liquors. 

Senecio. — Abdomen very tense ; feet and legs swollen ; pain 
in the lumbar region, and in the ovaries ; urine scanty and 
high-colored, or profuse and watery. 

Sulphur. — Dropsical, burning, swelling of external parts ; 
bluish spots on the skin ; it is dry and husky. 

• 

HYDROCEPHALUS. 

WATER IN THE HEAD. 

This disease is called chronic hydrocephalus by some au- 
thors, because some children are born with it. It may also 
be the sequela of acute meningitis of children. 

Symptoms. — This disease is sometimes developed in 
utero, and the child is born with a hydrocephalic head. I 
have seen cases in which the head was so large that it had to 
be punctured and let the water flow off before the child could 
be born. The disease is liable to develop at any time before 

the child is eight years of age. 

2 3 



354 THEORY AND PRACTICE OF MEDICINE. 

Hydrocephalic children have a delicate look, they look 
drowsy, languid, the eyes become crossed, nausea and vomit- 
ing are often present, coma and convulsions are premonitory 
symptoms of the accumulation of water on the brain. The 
fontanels enlarge, and the head acquires an immense size. 
Causes. — Scrofulous diathesis and infancy. 

Treatment. — I need not dwell long upon the treatment, 
for the majority die. Some may recover if seen in time and 
properly treated. If there are any meningial complications, if 
the child is restless and starting, then belladonna will be 
required. 

Apis. — Child lies in torpor ; delirium, sudden shrieking 
cries, squinting, grinding teeth, boring head in pillow, acute 
hydrocephalus. 

Apocymim. — Stage of exudation, sutures open and enlarg- 
ing, stupor, urine scanty. 

Arsenicum iodide. — This is good for the scrofulous cachexia. 

Digitalis. — Urine scanty, thick, turbid and blackish. 

Helleborns. — Head enlarging and urine scanty. 

Silicea. — Perspiration of the head and a tendency to soften- 
ing of the cranial bones. 

Calcarea carb. is one of our most valuable remedies for the 
scrofulous diathesis and a want of assimilation. 

The diet, clothing and hygienic regulations recommended 
for the scrofulous diathesis must be enforced. 

Dr. Von Grauvol says that he has known mothers to bear 
healthy children by taking calcarea phosphorica 6, and sul- 
phur 6, while enceinte, who had previously borne hydroceph- 
alic children. This is a hint that should be observed by all 
medical practitioners. 

HYDROTHORAX. 

DROPSY OF THE CHEST. 

This is an effusion of serum within the pleura. If the se- 
rum degenerates into pus the affection is called empyema. 



THEORY AND PRACTICE OF MEDICINE. 355 

Symptoms. — Usually the first indication we have is 
effusion within the pleural cavity, edema of the lower eye- 
lids. Next we notice a puffiness around the ankles and feet. 
The patient is soon distressed by dyspnoea on the slightest ex- 
ertion ; has to sit up, can not lie down for fear of suffocating. 
The countenance looks pale, or purple, and anxious, the pulse 
is irregular, often intermitting for two, sometimes for three 
strokes ; frequent spells of palpitation ; the urine becomes 
scanty ; there is sometimes asthmatic cough. 

Physical Signs. — These are the same as those of em- 
pyema. The diseased side enlarges until the ribs begin to 
bulge, and the intercostal spaces fill out even with the ribs. 
There is dullness on percussion ; the breathing becomes labo- 
rious. The heart is often pushed out of its normal position, 
and its beat may be heard on the right side of the sternum. 

Causes. — Pleuritis, organic diseases of the heart, and 
anything that will hinder the free circulation through the 
lungs. 

Prognosis. — If there is no organic disease of a serious 
character the prognosis may be favorable ; for with proper 
treatment the infiltration may often be arrested if detected in 
time. If the chest continues to fill, or if pus is present, then 
the symptoms are unfavorable. But if the constitution is good 
and the organic trouble is curable, then with the aspirator 
many patients may be saved. 

Treatment. — Apis. — This is always indicated for much 
swelling anywhere in the body ; especially when the urine is 
scanty. 

Apocynum. — This is a grand remedy in all forms of dropsy 
when the urine is scanty. Its specific action is on the kid- 
neys, increasing the flow of urine ; it is said that apocynum 
and cactus have cured general dropsy with mitral regurgi- 
tation. 

Arsenicum. — This is indicated for debility and prostra- 
tion ; suffocative spells, especially at night ; anxiety, restless- 
ness, and fear of death ; drinks often but little at a time. 



356 THEORY AND PRACTICE OF MEDICINE. 

Asparagus. — Countenance pale, wax-like, and bloated; 
visible throbbing of the heart, especially at night ; great full- 
ness of the chest. 

Bryonia. — Lips bluish, dry, and cracked ; stitching pains 
in the region of the heart ; want to lie perfectly quiet ; great 
thirst, and scanty urine. 

Digitalis. — Paleness of the face, blue lips, and swelling of 
the eyelids ; hydrothorax originating in organic diseases of 
the heart. When all else fails to give relief, then resort to 
the aspirator. 



HYDROPERICARDIUM. 

DROPSY OF THE HEART. 

There are two species of dropsy of the heart. 1. Active ; 
2. Passive. 

Symptoms. — The symptoms of the active species are 
the same as those of acute pericarditis. Those of passive 
dropsy of the pericardium are generally obscure. The pulse 
is small, frequent and irregular ; there is tendency to dyspnoea 
and syncope. The patient sits erect, and is afraid to move ; 
there is usually extensive dullness over the region of the 
heart, and of the sternum ; the sounds of the heart indistinct 
in the region of the heart, but more audible at the upper part 
of the chest. 

Prognosis. — Very unfavorable; yet under homoeo- 
pathic treatment there is often a chance of recovery. 

Treatment. — Any of the remedies recommended for 
dropsy may be resorted to in this disease. I only mention a 
few that are most highly recommended. 

Arsenicum. — Dropsy of the thoracic and abdominal cavities. 

Helleborus. — Proves valuable in hydrocephalus, hydrotho- 
rax, and anasarca. 

Spigelia. — Is recommended for dropsy of the internal parts. 

Warm baths to promote perspiration are often beneficial. 



THEORY AND PRACTICE OF MEDICINE. 357 

As a last resort, if you can be sure of your diagnosis, you may 
use the aspirator if you are sure that you can do so without 
piercing the heart or lungs. 

HYDROPS ARTICULI. 

DROPSY OF THE JOINTS. 

The remedies usually recommended are aconite, bryonia, 
iodine and Pulsatilla. If it is simply synovitis, then biniodide 
of mercury, rhus tox. and silicea are your remedies. In addi- 
tion to those internal remedies, I apply the iodine liniment to 
which I have already called your attention. It produces re- 
absorption of the fluids within. 

HYDROCELE. 

DROPSY OF THE SCROTUM. 

Arum, iodine and rhododendron are the remedies needed 
for internal use, and the liniment before mentioned may be 
used, and nearly all cases in children may be cured without 
any surgical interference. But if the treatment fails then you 
must tap the scrotum and draw off the fluid and inject a dilute 
aqueous solution of iodine and iodide of potash. After the 
solution has remained for a few minutes let it flow out through 
the canal. The iodine sets up an inflammation which pre- 
vents an accumulation of water in the scrotum again. 



358 THEORY AND PRACTICE OF MEDICINE. 



URINARY SYSTEM. 

"Nephritis — Inflammation of the Kidneys. 
Granular Disease of the Kidneys. 
Gravel. 
Kidneys. <{ Urinary Calculus. 

Hematuria — Bloody Urine. 

Ischuria Renalis — Suppression of Urine. 

Diabetes — Immoderate flow of Urine. 



NEPHRITIS. 

INFLAMMATION OF THE KIDNEY. 

There are two stages of this affection, called ACUTE and 
chronic. Without care the latter may be often overlooked. 

ACUTE NEPHRITIS — MORBUS BRIGHTII — BRIGHT'S DISEASE. 

Symptoms. — Pain in the region of the kidneys, extend- 
ing along the course of the ureter from the neck of the bladder 
to the groin. The pain is deep-seated, circumscribed, or dif- 
fuse, acute or dull ; sometimes only felt upon pressure, but 
always increased by firm pressure. Instinct directs the patient 
to incline to the affected side and bend the limb, thereby re- 
laxing the muscles of the loins. Hence, he lies on the affected 
side or back, and draws up one or both lower extremities. 
Nausea and vomiting are often present. The pulse is full, 
hard, and frequent at first, but becomes small as the disease 
advances ; the tongue is covered with a white fur. The bowels 
are costive, tympanitic, and painful ; there is an anxious ex- 
pression of countenance and depression of spirits. There is 
frequent desire to pass water, which is scanty, highly-colored 
or smoky-looking, albuminous, and of high specific gravity. 
If the urine be examined by the microscope, blood corpuscles 
may be seen in it, and granular casts of the minute tubes of 



THEORY AND PRACTICE OF MEDICINE. 359 

the kidneys, consisting of numerous spheroidal tubes of epithe- 
lium, the kidneys being in an active state of congestion, if not 
of inflammation. If the urine be tested by heat and nitric acid, 
it will deposit albumen. This condition has been called des- 
quamative nephritis, owing to the rapid separation of epithe- 
lium which goes on. The morbid anatomy of the kidney 
shows it to be small, hard, and granular. 

Causes. — Nephritis may follow or be complicated with 
fever, especially scarlet fever. Alcoholic liquors, irritating 
drugs, exposure to wet and cold, are fruitful causes of nephri- 
tis. Dr. G. Johnson says that out of two hundred cases ana- 
lyzed, it was found that 29 per cent, were caused by intoxi- 
cating drinks; 25 per cent, was due to exposure; and 12 per 
cent, arose from scarlet fever. 

Diagnosis. — In lumbago the pain is in the lumbar mus- 
cles, and is aggravated by motion ; while the pain in nephri- 
tis is worse on pressure, and not by motion, and then again the 
pain follows the course of the ureter, and there is frequent and 
painful micturition. 

Prognosis. — Favorable. — The early abatement of 
fever and pain ; followed by a copious flow of highly-colored 
urine, mixed with mucus and pus. 

Unfavorable. — Little or no secretion of urine, with fre- 
quent and painful efforts to pass what is secreted. Hectic 
fever preceded by rigors ; the pain suddenly ceases ; hiccough, 
delirium, and cold extremities supervene, followed by death. 

Sometimes, unless on your guard, you may be mistaken 
as to the character and location of the real disease. If ne- 
phritis, as is sometimes the case, is not accompanied with pain, 
and the symptoms point to the brain, stomach, and bladder ; 
then if you treat those reflex symptoms, instead of the real 
symptoms of the disease, you will make shipwreck of your 
patient. When you are in doubt, then, analyse the urine, 
with heat and nitric acid, and if you find albumen, and if you 
find blood mixed in the urine, then you may be sure that the 
patient has nephritis ; and the other symptoms are only reflex. 



360 THEORY AND PRACTICE OF MEDICINE. 

Treatment. — Aconite. — Acute stage for fever; reten- 
tion of urine, with stitches in the kidneys ; so giddy cannot 
sit up in bed. 

Cannabis sativa. — Shooting pains along the ureters to 
the groin ; painful urging to urinate, passing only a few 
drops of bloody, burning urine; burning during and after 
urination. 

Cantharis. — Shooting, cutting, or tearing pains in the loins 
and in region of the kidneys ; constant desire to urinate, pass- 
ing but a few drops at a time, sometimes mixed with blood ; 
vomiting, with violent retching and severe colic. 

Chelidoninm. — Desquamative nephritis ; renal irritation ; 
cylinderical casts with epithelial cells. 

Terebinthina. — Scanty, dark, smoky, bloody urine ; acute 
hyperaemic state of the kidneys ; much hemorrhage ; renal 
tubes, but no epithelial cells in the blood ; albumen present 
when blood is present. 

CHRONIC NEPHRITIS. 

CHRONIC BRIGHT'S DISEASE. 

In this stage of nephritis it is known as granular kidney, 
gouty kidney. 

Symptoms. — The chronic form may be the result of 
an acute attack of nephritis, or it may come on insidiously. 
The urine is scanty or almost suppressed, occasionally bloody, 
and loaded with albumen ; there is frequent micturition, dull 
pains in the loins, sometimes shooting to the groins ; nausea, 
pain in the epigastrium increased by pressure, and in some 
cases, vomiting. The patient's face becomes pallid, pasty, and 
edematous, so that his features are flattened, and there is loss 
of appetite ; acrid eructations ; his urine is found to be of less 
specific gravity than natural, as shown by the depth to which 
the urinometer sinks below its surface ; it is also albuminous 
and coagulable by heat and nitric acid. There is most al- 
bumen at the beginning of the disease, because the kidneys 



THEORY AND PRACTICE OF MEDICINE. 361 

are more congested ; but it is of lowest specific gravity at the 
end, when the urinometer may go down to 1.004, an< ^ then 
the quantity of urine is very small. 

I wish to say here that experimenters are not agreed as to 
the specific gravity of the urine in health. It is safe to say 
that in different individuals the specific gravity, in healthy 
urine, ranges from 1.005 to 1 '°33^ anything above or below is 
considered unhealthy. 

Complications. — Anasarca and ascites; bronchitis, 
diarrhea, dyspepsia, constant vomiting ; pleurisy, peritonitis, 
pericarditis, pneumonia ; coma ; chronic rheumatism ; and or- 
ganic diseases of the heart and liver ; and uraemia. 

Diagnosis. — From the acute by a reduction in the den- 
sity of the urine, with diminution of its solids ; excessive 
reduction of the coloring matter of the blood. 

Prognosis. — Is grave, but by early observance of the 
disease, and judicious treatment, patients may recover. The 
favorable symptoms are a gradual disappearance of albumen 
from the urine, and its increasing specific gravity ; moisture 
of the skin. 

Unfavorable. — Suppression of urine, coma, and the ap- 
pearance of complications. 

Uraemia. — This is a poisoned condition of the brain 
from urea. The kidneys being diseased, are unable to elim- 
inate the urates from the blood, and hence they produce urae- 
mic poisoning of the brain, producing delirium, convulsions, 
coma, and death. 

Causes. — Predisposing. — The scrofulous diathesis. 
Of seventy-four fatal cases recorded by Dr. Bright, nineteen 
were under thirty, fifty under fifty, thirteen above fifty, and 
four above sixty. 

Exciting. — Impure air ; intemperance ; mechanical inju- 
ries ; cold ; scarlatina. 

Anatomical Characters. — Christison enumerates the 
following condition of the kidneys : 1. Congestion of the kid- 
neys with enlargement. 2. A granular deposition into its cor- 



362 THEORY AND PRACTICE OF MEDICINE. 

tical and tubular textures. 3. Deposition of a homogeneous 
yellowish-gray matter, with similar atrophy. 4. Disseminated 
tubercles. 5. Induration of semi-cartilaginous hardness. 6. 
Atrophy, from disappearance of the proper renal structure, with 
little or no deposition. 7. Mere anaemia or paleness. 

Dr. George Johnson claims that there is an increase in the 
quantity of fat naturally existing in small proportion in the 
epithelium cells lining the urinary tubules. This being true, 
then Bright's disease must be regarded as a fatty degeneration 
of the kidneys, bearing a close analogy with the fatty liver. 

Treatment. — Arsenicum. — Chronic disease ; diminish- 
ed urine, with albumen, renal epithelium, fibrine casts, and 
blood-corpuscles ; post-scarlatinal nephritis ; ascites, hydro- 
thorax, and general anasarca ; granular or fatty degeneration. 

Acidum phosphoricum. — Said to be beneficial in amyloid- 
starchy degeneration of the kidneys ; from suppuration or 
other cachexia. 

Colchicum. — Granular degeneration from lead-poisoning, 
decreased elimination of the organic solids. 

Nux vomica. — The first to be given to hard drinkers, and 
those being used to taking strong medicines. 

Opium. — Inursemic poisoning of the brain, the patient be- 
comes delirious, stupor, and coma. 

Phosphorus. — Fatty degeneration of the kidneys, albumen 
and exudation cells in the urine. 

Plumbum. — Morbus brightii ; contracted kidneys ; granu- 
lar degeneration. 

Several cases have been reported as being greatly benefited 
by Dr. Hall's method of slushing the colon with warm water 
three times a week. This being true, then homoeopathic 
remedies will greatly assist in performing a cure. It is said 
that patients have been greatly benefited by an exclusive milk- 
diet when other treatment had failed. An adult should take 
at least a gallon of milk within the twenty-four hours. It may 
be taken cold or tepid. A vegetable diet is more beneficial 
than the nitrogenous products. Patients should have plenty 



THEORY AND PRACTICE OF MEDICINE. 363 

of out-door exercise. Warm baths are often grateful and ben- 
eficial to the patient. If blood coagulates in the bladder, you 
must inject warm water and then draw off with a double 
catheter. 



CALCULUS— STONE. 

GRAVEL. 

If urine lets fall a precipitate after being voided, it is called 
a sediment, but if the precipitate takes place in the kidneys 
or bladder, it is called gravel. When gravel lodges in any of 
the urinary passages and becomes concrete, it is called stone. 

There are three principal varieties : 1. Uric or lithic de- 
posit, this forms a pink or brick-dust sediment, called red- 
gravel. 2. Phosphatic deposits, called white gravel. 3. Ox- 
alic deposits. These may occur in the form of minute crystals 
diffused through the urine, and only to be detected by the 
microscope; or more rarely, in the form of small calculus 
concretions resembling hemp seeds, one of which may lodge 
in the bladder and increase till it forms a mulberry calculus. 

Renal Calculi. — The most frequent source of stone is 
the formation of small calculi in the kidneys, which passes into 
the bladder, and there deposits are added until it becomes 
quite a large stone. The passage of calculi through the ure- 
ters often causes excruciating pain along the ureter to the 
bladder. 

Vesical Calculi. — Stone in the bladder is usually the 
result of the passage of a renal calculus, and when it reaches 
the bladder, it is enlarged by precipitation from the urine. 
When formed its presence produces a great deal of pain in 
proportion to its smoothness or roughness. There is frequent 
desire for micturition, and often a discharge of blood. Stone 
occurs both in women and boys It is, however, not frequent 
in women, owing to the fact that the urethra is short and 
usually the calculus passes off before becoming large. 



364 THEORY AND PRACTICE OF MEDICINE. 

Diagnosis. — The calculus diathesis may be known by 
an examination of the urine. The lithic diathesis is charac- 
terized by yellow, red, brick-dust, or pink, sandy deposits. The 
phosphatic diathesis is characterised by white sediment. Ox- 
alic diathesis is suspected by the darkish color of the urine, 
which deposits a darkish sediment. If a drop of the sediment 
is placed under the microscope it displays myriads of crystals 
of various shapes and sizes. If the patient suffers during the 
day when exercising, but free from pain at night when quiet, 
then stone in the bladder may be suspected. But if the suf- 
fering is greatest at night then we may suspect that enlarged 
prostate gland is the cause. The only positive test is the use 
of the sound, which if difficult to introduce is evidence that 
the prostate gland is enlarged. But there may be enlarged 
prostate in connection with stone, hence the metallic click 
heard or felt when the sound comes in contact with the stone 
is proof positive of its presence. In order to make a thorough 
test the examination should be made when the bladder is full 
of urine. I shall only refer to the treatment of the calculus 
diathesis, for when stone has already formed then a surgical 
operation is the only rational treatment. 

Treatment. — Renal Calculi. — Berberis — Urine dark 
or bright yellow, or red, with sediment ; blood red, speedily 
becoming turbid, depositing thick mucus and bright red mealy 
sediment. 

Bryonia. — At times urine deposits white sediment, at other 
times the deposit is a whitish sediment. 

Coccus cacti. — Urinary calculi, with violent colic, hsema- 
turia, large deposit of uric acid and of urates, pains lancinat- 
ing, extending from kidneys into bladder. 

Eupatorium perfoliatum. — Urine dark brown, depositing a 
whitish, clay-like sediment. 

Lycopodium. — Urine dark-red, deposits a red, sandy sedi- 
ment ; before passing water, the child screams with pain ; red 
sand on the diaper. 

This remedy established my faith in homoeopathy which 



THEORY AND PRACTICE OF MEDICINE. 365 

nothing can shake, for while practicing allopathy I regarded 
lycopodium as inert, but when I saw a patient with the red 
sand in the urine, and saw how rapidly it disappeared by the 
action of lycopodium, all doubt was removed from my mind, 
and I then knew that homoeopathy is the true science of 
therapeutics. 

During the passing of renal calculi the pain is intense. 
Aconite, berberis, chamomilla, gelsemiitm and nux vomica are 
indicated. 

I have frequently given relief by saturating a cloth with 
choloroform and applying over the ureter at the seat of pain ; 
this gives instantaneous relief. The spasm of the ureter is 
broken and permits the calculus to pass into the bladder, but 
if it is large it may only pass down a few inches when the 
spasm returns and the chloroform has to be repeated. 

Vesical Calculi. — The same remedies as recommended 
for renal calculi are beneficial in this also. 

I had a case in which the red sand was so copious, urine 
scanty, and the sand so coarse, that the indicated remedies 
failed to give prompt relief, and before suggesting an exami- 
nation, I gave the patient fifteen grains of citrate of lithia 
three times a day, and in three days the urine became co- 
pious, and two tablespoonfuls of red sand was deposited ; some 
of the grains or crystals were as large as grains of wheat. 
The patient's diet should be changed. It is supposed that 
too long continuance of a diet of oysters, shell fish, and con- 
stant use of hard or lime-stone water, has a tendency to in- 
crease the trouble. 

HEMATURIA. 

BLOODY URINE. 

Symptoms. — If not produced by an injury, there is 
pain or aching over the region of the kidneys, followed by a 
bloody discharge of urine. If the blood and urine are thorough- 
ly mixed, then we know that it came from the kidneys ; but 
if it is clear blood it is from the bladder. 



366 THEORY AND PRACTICE OF MEDICINE. 

Diagnosis. — Bloody urine is distinguished by its color 
and dark deposit. 

Causes. — It may be caused by external injury, or irrita- 
tion of the kidneys. It is, however, generally a forerunner of 
inflammation of the kidneys. 

Treatment. — Cantharis. — Urine contained coagulated 
blood ; urine contained bloody filaments, then blackish, coagu- 
lated masses of blood, at last mucus. 

Chimaphila. — Urine is offensive, turbid, containing ropy or 
bloody mucus and depositing a copious sediment. 

Hamamelis virginica. — Hematuria ; passive congestion 
of the kidneys ; dull pain in the renal region. 

Millefolium. — Constant desire to urinate ; hsematuria; urine 
dark. 

Terebinthina. — Bloody urine, dark and smoky. 



ISCHURIA RENALIS. 

SUPPRESSION OF URINE. 

Symptoms. — There is weight in the loins, frequent 
pulse, heat of skin, flushed face, headache, nausea, and vomit- 
ing. About the third day drowsiness sets in with edema of 
the face, or of the limbs and entire body. About the fourth 
day coma sets in followed by death in a few days. At first 
the bladder is found to contain a small quantity of muddy 
urine, but when the disease is fully formed there is complete 
suppression. 

Causes. — Pre-existing disease of the kidney, excited into 
activity by blows or falls, or exposure to wet and cold. The 
action of certain poisons, as digitalis, co7 r rosive sublimate, and 
cantharides. Acute inflammation of the kidneys. 

Diagnosis. — In suppression there is no urine in the blad- 
der ; while in retention the bladder is full, as is ascertained by 
placing the hand above the pubic bone, when a round tumor 
may be felt. 



THEORY AND PRACTICE OF MEDICINE. 367 

Prognosis. — The disease may yield to treatment if the 
patient is seen early ; but if the patient is not relieved in a short 
time it proves fatal. 

Treatment. — Aconite. — Is indicated for inflammation 
of the kidneys with retention or suppression of the urine. 

Apis. — Inflammation of the kidneys, during or subsequent 
to eruptive diseases; the urine may be almost entirely sup- 
pressed, loaded with tube casts. 

Terebinthina. — Urine scanty, black, epethelial sediment, 
bloody, albuminous, on the borders of suppression. 

DIABETES. 

IMMODERATE FLOW OF URINE. 

There are three forms of this disease : 1. Diabetes insipi- 
dus. 2. Diabetes mellitus. 3. Diabetes chylosis. 

Diabetes Insipidus. — This is characterized by a large 
flow of limpid urine without any trace of sugar. 

Symptoms. — Emaciation, depression of spirits, debil- 
ity, anxious expression of countenance, thirst, gnawing sensa- 
tion at the stomach, dyspepsia, white tongue, constipation, 
.dry skin, irritable bladder and greatly increased secretion of 
urine. 

There are three conditions of urine usually found in this 
form of diabetes. 1. There is simply an increase of water, 
without any change in the other constituents. 2. Sometimes 
urea is deficient. 3. The urea is in excess. These are the 
non-saccharine conditions of diabetes insipidus, to which Dr. 
Willis has given the names hydruria, anazoturia, and azoturia. 
In the first and second varieties the urine is of very low den- 
sity (in one case of the first form 1.001 — Christison) ; in the 
third variety the density is high, (commonly 1.030 to 1.035, 
but sometimes as low as 1.020 to 1.024). 

Causes. — Too great a supply of liquids, especially spir- 
itous liquors ; hysteria ; granular disease of the kidneys. 



368 THEORY AND PRACTICE OF MEDICINE. 

Prognosis. — If there is organic disease of the kidneys 
then the case is very unfavorable ; but if there is no organic 
disease, then the symptoms are favorable. 

Treatment. — Ignatia, — Frequent profuse passage of 
watery urine. 

Murex. — Urine very pale and excessive. 

Scilla. — Pale watery urine. 

Helonias. — Great flow of insipid urine. 

Diabetes Meixitus — Saccharine Urine. — This dis- 
ease is characterized by diabetic urine. Diabetic urine con- 
tains diabetic sugar. That is the sweet principle of most acid 
fruits. It is also termed starch-sugar, sugar of fruits, grape- 
sugar, glucose, etc It is called mellitus because it has the 
sweetness of mel — honey. 

Symptoms. — This disease comes on gradually, and it 
is often a long while before our attention is called to it. The 
patient complains of weakness of the limbs with general de- 
bility. The urine on being examined, is found excessive in 
quantity, of a pale color, wanting its proper odor, and contain- 
ing sugar in greater or less quantity. There is inordinate ap- 
petite, generally accompanied by dyspeptic symptoms ; exces- 
sive thirst ; constipation ; the tongue is clammy, and red at the 
edge, or clean, or white with a brown streak down the mid- 
dle ; the gums are red and tender ; the throat dry ; the breath 
has often a sweetish odor like that of hay, or it has a smell of 
chloroform, which is diagnostic of the disease. The urine is 
very excessive, with a faint odor as of apples (apparently due 
to. a large secretion of glucose, for as this diminishes the odor 
correspondingly declines), and a specific gravity 1.035 to 1.050. 
The skin is dry, harsh, and scaly ; debility and rapid emaci- 
ation. The mind is generally affected, the power of attention 
being weakened, and the disposition being rendered melan- 
choly, anxious, and irritable. The temperature is always less 
than normal, ranging from 97 to 94 . It is estimated that 
thirty pints of urine of the specific gravity of 1.040, which is 



THEORY AND PRACTICE OF MEDICINE. 369 

about the heaviest, contains nearly four pounds of sugar. It 
is said that when the urinometer stands above 1.030, we may 
infer that sugar is present. 

Diabetic Test. — I will only call your attention to Trom- 
mer's test. Mix a test-tube half full of the suspected urine, 
to this add about two drops of a solution of sulphate of copper, 
or enough to make a slightly blue tint. Then you add an ex- 
cess of liquor potassa to clear up the mixture by re-dissolving 
the precipitate which it at first produces. If the mixture is 
boiled over a spirit-lamp there will be a reddish-brown pre- 
cipitate of the sub-oxide of copper, if there is sugar present ; if 
not the precipitate will be that of black oxide of copper. 

Cause. — The Pathological Society, of London, now claim 
that the seat or cause of diabetes is in the pancreas, liver, or 
duodenum ; and that it arises from a disturbance of duodenal 
digestion, caused by pancreatic or hepatic organic disease. 

Brunton says : Although diabetes was formerly associated 
with albuminuria, and other diseases of the kidneys, we know 
that these organs are not at fault, and that they only separate 
from the blood the excess of sugar which it contains. The 
blood always contains more or less sugar, but unless the amount 
of sugar be more than one-third per cent, it is not eliminated. 
The sugar found in the urine is not the cause of the trouble, 
but is the result of some pathological condition outside the 
kidneys. 

Pathology. — There is no change in the kidneys except 
that produced by over-work in trying to eliminate the excess 
of sugar in the blood as an abnormal product. As already- 
stated, the pathological changes are to be found in the pan- 
creas, liver or duodenum. As evidence of this fact, there is a 
want of power to assimilate and employ for the nourishment 
of the body those carbo-hydrates which enter into the compo- 
sition of the food, and, on the other hand, a perverted change 
of the carbo-hydrates, by which they are converted into diabe- 
tic sugar — a product incapable of oxydation and assimilation, 
and therefore excreted by the kidneys as useless and injurious. 

24 



370 THEORY AND PRACTICE OF MEDICINE. 

Owing to some dyscrasia of the liver, the sugar, which ought 
to be available for the maintenance of the body, enters the 
blood, leaves it again unchanged, and is discharged in urine. 

Prognosis. — Favorable. — Moist skin, moderate appe- 
tite. Cutaneous eruptions ; gradual disappearance of sugar in 
the urine. 

Unfavorable. — But few recover under twenty years of 
age. Spare habit, unhealthy location ; increase of sugar in the 
urine ; tendency to tuberculosis. The disease often lasts for 
several years before proving fatal. Owing to frequent relapses, 
you should not promise a permanent cure until the patient is 
free from the disease twelve months. 

Treatment. — Acidum phosphoricum. — Drs. Dalzell, 
Harvey, Holland and Wilde, of England, claim to have cured 
many cases with the ix dilution of this remedy. The sugar 
began to disappear at the end of the fourth week, and the pa- 
tients were well in four months. 

Large doses of the crude medicine increase the sugar in 
the urine ; thus demonstrating its homceopathicity. 

Uranium nitricum. — Drs. Cornell and Holland have re- 
ported cures with this remedy. On February 18th, 1874, 
1-6 grain was given in water three times a day, and increased 
to 1-3 grains. On March nth, specific gravity 1.038; much 
sugar; 21st, specific gravity 1.021, sugar a trace. April 8th, 
specific gravity 1.025, no sugar ; 15th, specific gravity 1.024, no 
sugar ; 25th, specific gravity 1.025, no sugar. That is a very 
encouraging report in such a grave disease. 

Helonias. — Large quantities of sugar in the urine, with 
emaciation, thirst, restlessness, melancholy, etc. 

Terebinthina, arum triphyllum and other remedies, are 
mentioned as being useful in this disease. Mm r iate of qui- 
nine and plumbum are recommended highly for the removal . 
of sugar from the urine. 

Diet. — The patient may be allowed all kinds of meat, 
oysters and soup, but no vegetables containing starch ; eggs 
and skim-milk may be allowed freely. Four to six pints of 



THEORY AND PRACTICE OF MEDICINE. 37 1 

skim-milk may be taken daily. One patient took five pints 
a day, and in six days the specific gravity fell from 1.040 to 
1. 01 7; the patient became stout and strong. The patient 
should eat no bread except "diabetic bread," that is, bread 
made from eight parts of glnten, and two parts of bran, freed 
from starch, and a little butter. The patient may be allowed 
cheese, cream, butter, greens, spinach, turnip-tops, mush- 
rooms, water-cress, mustard-and-cress, cucumbers, lettuce, rad- 
ishes, celery, vinegar, oil, pickles, custard without sugar, and 
olives. Tea and coffee may be taken without sugar. 

As you will often be asked how to distinguish between 
mushrooms and toadstools, a poisonous fungus, which resem- 
bles mushrooms so closely that it takes an expert to tell the 
difference, I give you the following test. If you stew some 
sliced onion with the suspected product, if it is mushrooms 
there will be no change in the color. But if it be toadstool, 
then the onion turns it black. 

Diabetes Chyeosus — Mieky Urine. — Symptoms, — 

The urine is generally abundant, and of a milky appearance,, 
and varying in density from 1.010 to 1.020. A short time 
after its discharge, it sometimes coagulates into a white gel- 
atinous substance, and after a long interval, separates into- 
a clear yellowish fluid and white clot. Sometimes a white: 
creamy substance rises to the surface. This disease is of rare 
occurrence ; but you should understand its nature. 

I am not sure but that children have been doctored to 
death for worms, when diabetes chylosus was the trouble. It 
is a well-known fact that in times past when any one passed 
milky urine, it was said to be caused by worms. 

Treatment.— Apis. — Urine milky. 

Cina. — Passage of much urine all day, which becomes 
turbid soon after its passage. 

Phosphorus. — Profuse, watery urine ; like curdled milk. 

Phosphoricum acidum,.—L<2LXgz quantities of milky urine 
passed at night. 



372 THEORY AND PRACTICE OF MEDICINE. 



DISEASES OF THE BLADDER 

AND ITS APPENDAGES. 

Cystitis Inflammation of the Bladder. 

f Spasm of the Blad-"| 

Dysuria <^ er /fu^V/ > Difficult Urination. 
] Spasm of the Ure- / 

[ thra. J 

Enuresis Incontinence of Urine. 

Retentio Urin/e Retention of Urine. 

Prostatitis i Inflammation of the Prostate Gland. 

Urethritis Inflammation of the Urethra. 

CYSTITIS. 

INFLAMMATION OF THE BLADDER. 

This disease may be acute — cystitis acuta — and chronic 
cystitis chronica. The symptoms are the same, only there is 
little or no fever in the chronic variety. 

Symptoms. — Acute pain, swelling and tension in the 
region of the bladder ; pain and soreness, increased upon pres- 
sure, above pubes, or in the perinseum ; frequent micturation, 
painful discharge of urine, in small quantities ; or complete 
obstruction to its passage ; tenesmus ; vomiting. 

In the chronic form the mucous membrane of the blad- 
der, by repeated or continued irritation produced by calculus, 
by stricture, by disease of the prostate, kidneys, or other causes, 
has become thickened, indurated, ulcerated, and pours out a 
large quantity of mucus and pus, which added to the urine, 
gives to it the appearance of whey. There is often a discharge 
of blood. 

Causes. — Mechanical injury ; falls on the abdomen when 
the bladder is distended ; local irritation by calculi ; the in- 
flammation of gonorrhoea extended along the urethra ; spasmo- 



THEORY AND PRACTICE OF MEDICINE. 373 

die or permanent stricture ; all the usual causes of inflamma- 
tion ; cantharides ; stimulant urethral injections. 

Diagnosis. — The large amount of tenacious mucus found 
in the urine after standing ; and the pain running up from 
the bladder to the loins, are diagnostic symptoms of cystitis. 
While pain running from the loins down the ureters with ten- 
derness over the kidneys, is diagnostic of inflammation of the 
kidneys. 

Treatment. — The first object in the treatment of this 
disease is the removal of the cause. If caused by calculus or 
gravel, then medicines will be of no avail, and you must re- 
sort to surgical means. 

Aconite. — Dry, hot skin, intense thirst and great restless- 
ness ; frequent and violent urging to urinate, with burning in 
the bladder ; painfulness of the region of the bladder. 

Berberis vulgaris. — Blood-red urine, depositing a copious, 
slimy, bright-red bran-like sediment ; dark urine, with trans- 
parent jelly-like sediment. 

Cannabis indica. — Inflammation of the bladder; painful 
discharge by drops of bloody urine. 

Cantharis. — Violent pains and burning heat in the blad- 
der ; constant desire to urinate, with scanty emissions of dark 
or bloody urine ; with burning and cutting pains, so severe 
the patient screams aloud. 

Chimaphila. — Copious mucus or albuminous discharge. 

Digitalis. — Frequent sharp, cutting pains in the neck of 
the bladder, as if a straw was being thrust back and forth. 

Dulcamara. — Painful pressing down in the region of the 
bladder ; urine turbid and white, or reddish and burning, de- 
positing at times a red, at times a white sediment. 

Mercuriits. — Constant desire to urinate, with scanty emis- 
sions of dark-red urine, soon becoming turbid and fetid. The 
urine looks as if mixed with blood, with white flakes, or as if 
containing pus. 

Ruta graveolens. — Pressure on the bladder as if continu- 
ally full, with scanty discharges of green urine. 



374 THEORY AND PRACTICE OF MEDICINE. 

Sarsaparilla. — Tenesmus of the bladder, with cutting pain 
during micturation ; urine red, fiery, turbid, containing long 
flakes ; the urine contains large quantities of pale sand ; chil- 
dren cry before and during micturation. 



DYSURIA. 

DIFFICULT URINATION. 

Irritability, spasm of the bladder and urethra, either or all 
combined, produce strangury or difficult urination. As I 
mention the remedies they will illustrate the symptoms in 
each case. 

Treatment. — Apis. — Stinging pains in the urethra 
during micturation. Sensation as if something in the abdo- 
men would break. 

Belladonna. — Difficult micturition, the urine being passed 
drop by drop, with frequent urging. The urine is yellow and 
turbid, or the color of gold. 

Cannabis indica. — Violent burning in the urethra during 
and after micturition. 

Cannabis saliva. — Strangury ; burning while urinating, 
but especially just after. 

Canlharis. — Very frequent micturition, with burning and 
cutting pains, so severe the patient screams aloud. 

Copaiva. — Catarrh of the bladder, with dysuria. 

Capsicum. — Burning smarting in the uretha ; the urine is 
emitted in drops. 

Conium. — The flow of urine suddenly stops, then con- 
tinues at short intervals, during spasms of the neck of the 
bladder or urethra ; cutting pain in the urethra while urinat- 
ing ; vertigo, particularly when lying down. 

Gelsemium. — This is a sovereign remedy for spasm of the 
urethra and bladder. 

Mercurius cor. — Violent inflammation of the neck of the 
bladder, with extreme tenesmus and burning. 



THEORY AND PRACTICE OF MEDICINE. 375 

Nux vomica. — Burning and lacerating pain in the neck of 
the bladder and urethra ; painful, ineffectual desire to urinate, 
with discharge of a few drops of red, bloody, burning urine. 

Pareira brava. — Strangury, with violent, pains in the 
bladder. He cries aloud and can only emit urine when on 
his knees. 

Sulphur. — Obstinate cases ; the urine is mixed with mucus 
or blood, very fetid ; burning in the urethra during mictur- 
ition. 

ENURESIS. 

INCONTINENCE OF URINE. 

This means an inability to retain the urine from any 
cause. 

Causes. — Reflex action, from brain complications, cold, 
or any thing that may produce a partial paralysis of the 
sphincter vesica, or relaxation of that viscus. 

Diagnosis. — If incontinence is caused by stone in the 
bladder, the patient is not troubled much at night. But if 
incontinence is caused by enlarged prostate gland, the patient 
is worse at night. The use of the sound is the only means 
of deciding the question. If a stone is discovered, then med- 
icine is of no avail, and surgical treatment gives the only 
show for relief. 

Treatment. — Acidum phosphoricum, belladonna and 
gelsemhim are almost specific for incontinence in the aged. 
For relaxed or paralytic condition of the sphincter, there is 
probably nothing better than gelsemhim. 

For alkaline urine, and in hysterical females, you will find 
relief from, cantharis, mix vomica, acidum phosphoriciun. 

For highly-colored and strong-smelling urine, you can call 
to your &\& podophyllum, calcarea carb., acid nitric, opium, lyco- 
podium, and acid benzoic. 

For worms you must look to cina, spigelia, or argentum 
nitrictan. 



3j6 THEORY AND PRACTICE OF MEDICINE. 

For diurnal incontinence, ferrum, sepia and silicea, are valu- 
able remedies. 

For profuse discharge of urine murex and scilla, are valu- 
able remedies. 

For children with uneasiness at micturation, you can re- 
sort to aconite, belladonna, cantharis, secalle, chloral hydrate, 
ferrum, mer curias, or chamomilla. 

It requires a great deal of care to manage children with 
this annoying complication. It requires very correct diagno- 
sis as to the remedy in each case. Therefore, you should pay 
strict attention to your materia medica. 



RETENTIO URIN^E. 

RETENTION OF URINE. 

You must never confound retention of urine with suppres- 
sion of urine. In the latter the fault is in the kidneys ; in the 
former the bladder may be full but the patient cannot pass it. 

Causes, — Cold, inflammation of the neck of the bladder, 
fibrinous exudation, thick tenacious mucus from catarrh of the 
bladder, prostatitis, or enlarged prostate gland, spasmodic stric- 
ture of the urethra, and organic stricture. Poisoning from 
cantharidies or fly-blister will often cause retention of urine. 

Diagnosis. — When a patient does not pass any urine, 
and you find a tumor above the pubes, then you may infer that 
it is retention of urine, if the patient is a male ; but if a female 
then you have to diagnose between a full bladder and a dis- 
tended uterus. In that case the catheter and a digital exami- 
nation are your main reliance. If you do not find a distended 
bladder, and the catheter gives no evidence of urine in the blad- 
der, then the case is suppression and not retention. The next 
step in your investigation, if it is retention, is to find the cause, 
so as to enable you to make a judicious selection of your reme- 
dies, or if the cause is mechanical, then you must resort to sur- 
gery at once, and lose no time experimenting with remedies. 



THEORY AND PRACTICE OF MEDICINE. 2)11 

I have always been conservative in my practice of surgery, 
and if there was no immediate use for the catheter, then I 
would try the remedies a reasonable time before resorting to 
its use. If the symptoms lead me to suspect the possibility of 
stricture or stone, then I would use the sound, and if that gave 
no evidence of either of those complications then I would use 
the catheter, and give temporary relief until the remedies had 
time to act. 

I once learned a valuable lesson from an old German lady 
while I was in the old-school practice. I had a patient with 
retention of the urine, as was evident by the tumor above the 
pubis bone ; but as I disliked to use the catheter, I postponed 
the operation for four hours longer. As I was leaving the 
house the old lady referred to, asked me if she could put a 
warm onion poultice on the patient's lower bowels ; I gave my 
consent, and in four hours I returned with my catheter, but I 
did not use it, for the patient passed his urine within an hour 
after the onion poultice was applied. I have used the same 
treatment many times since, with the happiest results, and that 
too after warm water had been applied with no result. I pre- 
sume that the odor of the onion being inhaled had something 
to do with the result. That was when I knew nothing about 
homoeopathic remedies. 

Treatmente — Aconite. — From cold. 

Camphor. — Spasm at the neck of the bladder. If retention 
has been caused by absorption of cantharides blister, or an over- 
dose of that poison, then drop doses of the tincture of camphor 
on a lump of sugar every fifteen minutes for three or four hours, 
will usually antidote the poison and thus remove the retention. 

You must remember that similia deals only with patho- 
logical symptoms of disease, and not with those produced by 
poisons ; hence you must use antidotes for poisons and poten- 
cies for disease. 

Cantharis. — Urging to urinate ; cutting and tearing pains 
when caused by cold, etc. 

If retention of urine is due to the accumulation of mucus 



378 THEORY AND PRACTICE OF MEDICINE. 

in the urethra from catarrh of the bladder, then you must wash 
out the bladder with warm water, and give the treatment as 
laid down for chronic cystitis. 



PROSTATITIS. 

INFLAMMATION OF THE PROSTATE GEAND. 

Inflammation of the prostate gland is known by the ten- 
derness, and pain in the region of the neck of the bladder. 
The pain is sometimes excruciating, with constant desire to 
urinate. 

Treatment. — Aconite. — Pain in neck of bladder, with 
frequent painful urination. 

Belladonna. — Frequent desire to urinate ; vesical region 
very sensitive to pressure or jar. 

Apis. — Great irritation at neck of bladder, with frequent 
and burning urination. 

Iodine. — Swelling of the prostate gland. 

Pulsatilla. — Tenesmus in the neck of the bladder ; enlarge- 
ment of the prostate gland. 

Sometimes a hot sitz-bath gives temporary relief. If the 
patient is suffering intensely you may apply a little bella- 
donna ointment over the region of the gland. 

Solidego and saw palmetto are both highly recommended 
for enlargement and chronic inflammation of the prostate gland. 
Several cases have been reported as cured by the ix dilution 
of the tincture made from those two plants. They were given 
one at a time. 

While I was visiting in Florida, I learned that several per- 
sons had been cured of chronic prostatitis, by eating the ber- 
ries of a bush called pichi. The profession there had a fluid 
extract made, and have been using it to good advantage. 

I have tried the fluid extract of pichi in five-drop doses 
every three hours until relieved, and then increase the inter- 
val between the doses. The patient had received no relief 



THEORY AND PRACTICE OF MEDICINE. 379 

either by allopathy or homoeopathy. He was urinating nearly 
every half hour during the night and day, and his pains were 
great. He was unable to leave his room for months. After 
taking the pichi three or four days he began to improve, and 
was able to walk several squares, and his suffering was trifling 
compared to what it had been before. The patient improved 
for a few months, but finally died. A post-mortem revealed 
the fact that the prostate gland, bladder and urethra, were all 
diseased and sloughing. 

I would recommend you to use the pichi in enlargement 
of the prostate gland, if the usual remedies fail to give relief. 

URETHRITIS. 

INFLAMMATION OF THE URETHRA. 

This disease may be acute and chronic. I am now treat- 
ing of urethral inflammation independent of gonorrheal com- 
plications. I wish here to enter my protest against the habit 
of some doctors, with more egotism than brains, calling all 
urethral irritation gonorrheal. It is very humiliating to re- 
fined ladies and gentlemen to hear such imputations from 
their medical advisers. If you think so, I see no reason for 
exposing your patient. 

Symptoms. — Inflammation of the urethra is character- 
ized by soreness, tenderness, burning, and a scalding sensa- 
tion when urinating. 

Causes. — The mucous membrane of the urinary organs 
is similar to that of the respiratory organs, and hence is 
liable to inflammation from the same causes. Cold damp 
weather, and the poisonous and irritating substances often 
found in the urine, produce non-gonorrheal inflammation both 
of the bladder and the urethra. This being true, then we are 
liable to have an irritation or chronic inflammation of the 
bladder and urethra until the cause is removed from the urine. 

Treatment. — Aconite. — Urine scanty, fiery, scalding 
hot, dark-red, and turbid. 



380 THEORY AND PRACTICE OF MEDICINE. 

Cannabis indica. — Burning and scalding, or stinging pain 
in the urethra, before, during and after urination. 

Cannabis sativa. — Burning while urinating, but espec- 
ially just after. 

Cantharis. — Before, during and after urinating, cutting 
pains in the urethra. 

Copaiva. — Inflammation of urethra, with great burning 
far back on urinating. 



NEUROLOGICAL DISEASES. 

NERVOUS SYSTEM. 

Neurosis Non-Inflammatory Nervous Affection. 

Encephalitis . .Inflammation of the Brain. 
Myalitis Inflammation of the Spinal Cord. 

{Cerebral Meningitis. 
Cerebro-Spinal Meningitis. 
Spinal Meningitis. 

Under the head of Neurosis belong all nervous affections 
unaccompanied by inflammation. 



HYPOCHONDRIASIS. 

LOW SPIRITS. 

The definition given of this condition is low spirits, mel- 
ancholy, tending to insanity. 

Symptoms. — The patient is gloomy, imaginary ; thinks 
that he has various diseases, when there is really nothing 
the matter. If you convince him that his ailments are im- 
iginary he will find some new trouble, and thus he will con- 
tinue until he has passed the whole list of organic functions. 
He may be dyspeptic, and hence his case becomes aggravated ; 
he fears danger and death. Sometimes organic diseases will 
produce hypochondriasis. 



THEORY AND PRACTICE OF MEDICINE. 381 

Causes. — Predisposing. — Hereditary melancholic tem- 
perament. 

Exciting Cause. — All causes of indigestion, excess of 
amusements, and everything that tends to depress the nervous 
centers. 

Diagnosis. — From simple melancholy from the more 
constant tendency to dyspeptic symptoms. From dyspepsia 
proper, by the affection of the mind being greater, that of the 
stomach less, than in idiopathic dyspepsia. 

Prognosis. — Is unfavorable. 

Treatment. — Nux vomica. — Hypochondrias is associ- 
ated with affections of the liver, irritability, and fractious 
disposition. 

Aurum. — Melancholy which nothing seems to affect; 
loathing of life, or a suicidal tendency ; religious melancholy ; 
uneasiness, apprehensiveness, sullenness, and indisposition to 
conversation. 

Arsenicum. — Melancholy, with debility ; also for the burn- 
ing pains sometimes complained of. 

Ignatia. — Melancholy from loss of friends or property. 

Pulsatilla. — Mild, tearful disposition, weeps often. 

Platina. — Low-spirited, inclined to shed tears, worse in the 
evening ; weeps with the pain. 

Anacardium orientale. — Hypochondriac mood in forenoon, 
dejected and desponding, with foolish, clumsy actions. 

Petroleum. — Sadness and despondency, inclination to weep. 

Sepia. — Anxiety — with fear, flushes of heat over the face — 
about real or imaginary evils. 

The patient should have plenty of out-door exercise, and 
some useful employment to divert his mind from himself. He 
should not be allowed to read any medical works, or patent 
medicine advertisements, that will in any way call his atten- 
tion to himself. 

I had a patient once who imagined that her stomach was 
full of worms, and that she could feel them come up in her 
throat. She sent for me one day to know if I could not 



382 THEORY AND PRACTICE OF MEDICINE. 

make a small trap to fit her mouth so as to catch the worms. 
I do not advocate the practice of deceiving patients, but I 
saw that medicines could have no effect upon her case, so I 
worked upon her imagination. I said that I had a remedy 
that could certainly destroy those worms and restore her to 
health again ; but I was afraid to give it to her unless she 
would promise to follow my instructions to the letter. She 
agreed to do so. I then filled a bottle with clean water and 
colored it a slightish pink by some inert substance. She was 
to take a teaspoonful every two hours. I explained to her 
that when she experienced a great commotion in the stomach 
then she might know that the worms were dying, and she 
must stop the medicine at once ; for after the worms were 
dead, then the medicine would begin to act upon the stomach, 
and then there would be no hope of her recovery. I gave her 
one dose and told her to take another in two hours, and watch 
the symptoms, and stop the medicine as soon as she found the 
worms beginning to die. I was sent for in three hours, and 
found her apparently in great distress. She described the terri- 
ble agony of the dying worms, and felt that she would die with 
them. I told her to quiet down and let the worms die, and for 
her to try to go to sleep before the worms were dead, and then 
she would awake free from all disease. She slept for several 
hours, and awoke refreshed, and in her right mind, and got 
entirely well. The only explanation that I could offer my con- 
science for the deception played on my patient was that the 
end justified the means. That occurrence goes to prove what 
influence one mind can have over another. 

NEURALGIA. 

NERVOUS PAIN. 

Neuralgia wherever located is characterized by severe, sharp 
or burning pain. We have facial neuralgia of the fifth pair of 
nerves, and is commonly known as tic-doloureux. There is 
hemicrania or brow-ague, the seat of pain being just above the 



THEORY AND PRACTICE OF MEDICINE. 383 

eye-brow. Intercostal neuralgia (pleurodynia) is often associ- 
ated with an eruption of. clustered vesicles, called herpes zoster. 

Sciatica is a form of rheumatic-neuralgia of the sciatic 
nerve. We have neuralgia of the stomach called gastro- 
dynia ; neuralgia of the cardiac nerves, called angina pectoris ; 
also neuralgia of the liver and ovarian neuralgia. 

As I have already called your attention to the different 
forms of neuralgia when treating rheumatism, I shall only 
call your attention now to facial neuralgia. 

Treatment. — Aconite. — Facial neuralgia from cold, 
anxiety, with palpitation, quickened full pulse, and in pleth- 
oric persons. 

Arsenicum. — Burning and tearing pains, intermittent or 
periodic, worse at night or during rest, with extreme restless- 
ness and anguish, especially in weak persons. 

China or cinchona. — From malaria ; loss of animal fluids. 

Colocynth. — Sudden violent lanci nations, extending from 
the point of origin to a distance, chiefly on the left side. 

Coffea. — Nerve-pains, with restlessness and sleeplessness. 

Chelidoniinn. — Pain over right eye, with liver troubles. 

NERVOUS SICK=HEADACHE. 

Symptoms. — This affection usually commences in the 
morning on rising; the patient looks pale, dark around the 
eyes, the pupils contracted, and looking and feeling extremely 
ill. Giddiness, swimming in the head, throbbing of the 
temples, stupefying or agonizing, deeply-seated headache, 
often limited to one spot on the side of the head, on the fore- 
head, over the eyes, and increased by movement, noise, strong 
light, and any kind of mental perturbation. Nausea and 
vomiting, or retching, are sometimes very annoying. 

Causes. — Predisposing. — A hereditary nervous tem- 
perament. 

Exciting. — Any powerful impression made upon the pa- 
tient ; overjoy or grief, fright, or sudden loud noises ; mental 
or physical fatigue, deprivation of sleep or food. 



384 THEORY AND PRACTICE OE MEDICINE. 

Diagnosis. — From organic diseases of the brain, owing 
to the absence of fever. There may be congestion to the 
head, but no fever. 

Treatment. — Belladoiina. — Face flushed, eyes red and 
hot, head feels too large, severe frontal headache. 

Bryonia. — Violent pains in head, with vomiting of bitter 
fluids. 

Cocculus. — Sick-headache with much retching, and but lit- 
tle, except water or mucus, vomited. 

Coffea. — Nervous headache, with sleeplessness. 

Glonotnum. — Throbbing pulsating headache. 

Iris versicolor. — Copious vomiting of bilious matter. 

Nux vomica. — Congestive headache, with giddiness and 
constipation. 

Veratrum album. — Sick-headache, with prostration, cold 
sweat on the forehead. 

INSOMNIA. 

SLEEPLESSNESS. 

This is a condition in which a person is incapable of sleep- 
ing ; often lying awake for hours, or sometimes all night with- 
out sleeping a moment. 

Physiology of Sleep. — By recent experimental research, 
Durham and Hammond have found that the brain is almost 
bloodless during sleep, that the rapidity of the circulation is 
diminished, and that whatever increases the activity of this 
circulation favors wakefulness. At the meeting of the British 
Association in 1873, Professor Ferrier stated that he had known 
animals fall sound asleep on losing a large quantity of blood, 
a portion being of course drawn from the brain. At the same 
meeting, Dr. Forthergill affirmed that attacks of loss of con- 
sciousness are often found to depend upon an imperfect blood- 
supply to the brain, and are cured by the administration of 
remedies acting on the circulation and steadying the blood- 
pressure on the nerve centers. Dr. Carpenter thought that 



THEORY AND PRACTICE OF MEDICINE. 385 

activity of the brain was the functional expression of the 
changes going on between the capillary circulation and the 
substance of the brain itself — a conclusion which, he said, was 
confirmed by Prof. Ferrier's recent experiments on the brains 
of animals. The conclusion to be drawn from this testimony 
of the first scientific men of the day, is that whatever increases 
the circulation of the blood to the brain occasions wakefulness, 
while whatever lessens the supply induces sleep. 

Causes. — Indigestible food, or whatever causes dyspep- 
sia ; trouble, over-joy, or sad and unexpected news ; exhaustion 
both mental and physical ; alcoholic liquors and every thing 
that stimulates the brain are causes of sleeplessness. If the 
cause cannot be traced to irregular habits, indigestion, mental 
and physical exhaustion, then we may suspect trouble in the 
nervous centers, that may be a forerunner of insanity. 

Treatment. — Aconite. — Wakefulness from fright, agi- 
tation or anxiety, with febrile symptoms ; teething irritation. 

Belladonna. — Sleepy but cannot sleep ; throbbing in the 
head, pain or redness of the eyes. 

Chamoinilla. — Nervousness, palpitation from anger. 

China. — Wakefulness of convalescents ; disturbing dreams 
causing anxiety and starting, which remain for sometime after 
waking ; morbid effects of tea. 

Coffea. — Mental fret, and fret and friction ; patient cannot 
sleep for thinking ; excitement of all the organic functions ; 
agreeable excitement ; playfulness ; wakefulness of children 
and the aged. 

Gelseminm. — Sleeplessness ; a wide-awake feeling ; sleep- 
less from violent itching of face, head and shoulders ; sleepless 
during dentition ; face red ; in extreme cases one drop of the 
mother-tincture every half hour is often very beneficial. I 
advise this in preference to having a hypodermic doctor sent 
for. 

Hyoscyamus. — Light sleep broken by dreams ; nervous irri- 
tability ; excitement with depression of spirits ; disagreeable 
dreams. 



386 THEORY AND PRACTICE OF MEDICINE. 

Lachesis. — Feeling of intense weariness, worse in the 
morning ; palpitation ; confused thoughts ; jactitation all night 
with extreme nervousness ; melancholy. 

Nux vomica. — Sleeplessness consequent on errors of diet, 
excesses, the use of alcoholic drinks, coffee and other stimu- 
lants ; on immoderate strain of the nervous system by haste 
and worry of business ; on late hours of study, indigestion 
and constipation. 

Opium. — Sleeplessness, with acuteness of hearing ; clocks 
striking and cocks crowing at a great distance keep the pa- 
tient awake. 

A hop-pillow is often beneficial. A cup of warm malted 
milk at bed-time often proves grateful to the patient. Read- 
ing aloud often lulls a patient to sleep. A cold sponge-bath 
often produces sleep. 

If there should be brain complications, and your remedies 
fail to procure sleep, then I recommend that you give your 
patient one grain of extract lactuca, or lettuce opium, every 
hour. It procures refreshing sleep without any of the deleter- 
ious effects of opium, morphine and hydrate of chloral, so often 
resorted to by empirics. 

BRAIN=FAQ. 

This means mental exhaustion, and is common in nervous, 
excitable individuals. 

Symptoms. — The trouble comes on gradually ; the pa- 
tient takes cold easily ; he is cross, excitable ; sheds tears 
easily. The patient is annoyed by sleeplessness, loss of ap- 
petite, headache, and loss of memory. As the disease advances 
a good sedate man becomes surly and cross ; although he may 
have been temperate all his life ; but when in that condition, 
called brain-fag, he is apt to crave intoxicating drinks. He 
becomes melancholy, takes but little pleasure with those 
around him. 

Causes. — Over-work, both mentally and physically, and 
worry, are the principal causes of brain-fag. 



THEORY AND PRACTICE OF MEDICINE. 387 

Treatment. — Ignatia. — Alternate excitement and de- 
pression ; tendency to tears on slight cause ; sleeplessness ; 
fearfulness. 

Nux vomica. — Ailments after continued mental labor; 
worse after mental exertion ; can not read or calculate, for 
they lose the connection of ideas. 

Phosphorus. — This becomes one of our best remedies in 
brain-fag, owing to the fact that the phosphorus of the brain 
is consumed by mental exertion. If that be true, then low 
dilutions of phosphorus should be given after each meal. It 
is supposed that fish, lobsters and oysters contain large quanti- 
ties of phosphorus, and hence when taken as a diet they in- 
crease that supply to the brain which has been consumed by 
over-mental exertion. Pleasant company is essential to a 
tired brain. A cold bath followed by rubbing until the body 
is aglow is highly beneficial. 

It is not best to withdraw the patient too suddenly from 
his accustomed work, but he must relax gradually. It is re- 
corded of a miller, who had been used to the sound of his mill 
all his life, on being confined to his bed from sickness, was 
unable to sleep, and the most powerful opiates could not pro- 
cure sleep. The doctor was at a loss to know what to do, for 
if the patient did not get sleep soon he must die. All of a 
sudden the doctor seemed to realize that the mill was not run- 
ning. He asked why the mill was not running ; being in- 
formed that they feared the noise would disturb the patient. 
The doctor then realized what was the trouble, and ordered 
the mill to be started again. As the wheel began to revolve, 
the old miller turned his head and listened attentively for a 
few minutes, when a satisfactory expression passed over his 
countenance, and he soon fell asleep, and began to recover from 
that moment. 

Let me urge upon you the importance of allowing no whis- 
pering in 'the sick-room, it annoys the patient, for he is listen- 
ing to catch every sentence of an unfavorable prognosis. 
There should be no loud boisterous talking. The room must 



388 THEORY AND PRACTICE OF MEDICINE. 

be kept quiet, and persons talk in a clear tone, so that the 
patient catches every sound without an effort. Let no one 
approach you in the hall-way and begin asking you questions 
as to the condition of the patient unless you are far enough 
away that he can not hear your voices. 

I remember well of learning a grand lesson on this sub- 
ject when I was quite a young man. A traveler came along 
at night-fall and put up at a hotel. He was taken sick during 
the night, and my father's family physician was called in. 
The patient had a high fever, and craved cold water all the 
time, but at that time cold drinks were forbidden to all patients. 
After a few days the doctor gave up all hopes for his patient, 
and as he left the sick-room he met the landlord in the hall- 
way, but neglected to close the door after him, and the patient 
heard him repeat his unfavorable prognosis. The landlord 
urged the doctor to let his patient have cold water as he had 
to die any way, but the doctor utterly refused lest it might 
kill the patient at once. As the landlord entered the sick- 
chamber, the apparently dying man said to him, Mr. Grose, 
please give me some cold water, but he refused because the 
doctor had forbidden it. The poor suffering man said, Mr. 
Grose, I heard the doctor tell you that there was no hope for 
me, then why let me suffer, for I can bear the suffering of 
death bettei than this burning thirst. Mr. Grose told me that 
he could not resist any longer, and went immediately and got 
a pitcher of cold water, and set it on the table by the bed, and 
immediately left the room. On his return he found that the 
patient had drank about a quart of water ; he removed the 
pitcher, and sat down to see the patient die. In an hour or 
two the patient broke out in a copious perspiration. The doc- 
tor was astonished when he came in and found the patient 
perspiring and the rapid pulse abating, and he seemed to be 
dumfounded, but expressed the belief that the patient would 
recover. Mr. Grose then confessed what he had done. The 
patient recovered, and the doctor changed his practice, as to 
cold water, to my great delight, for he had drenched me many 



THEORY AND PRACTICE OF MEDICINE. 389 

a time with warm drinks prior to that period. The result 
proved that with aconite and cold water the patient might 
have been cured in one-fourth of the time. 

MELANCHOLIA SIMPLEX. 

SIMPLE MELANCHOLY. 

Definition. — Disorder of the intellect, with depression, 
often with suicidal tendency. It consists essentially in a state 
of mental pain ; in a vague feeling of anxiety, gloom, or de- 
pression. Life has lost its interest in the present and its hope 
of the future. 

Symptoms. — The patient is rational and intelligent, 
labors under no delusion, but is depressed by a tormenting 
self-accusation and poignant grief, which sometimes drives 
him by sudden impulse to suicide, or other violent acts. If 
the patient has any real or imaginary trouble, he is wedded 
to it, and broods over it continually. He becomes restless, 
despondent and can not sleep ; the pupils of the eyes dilate, 
tongue red and tremulous, headache, and loss of appetite. 

Treatment. — Aurum. — Suicidal melancholy. 

Arsenicum. — Restless depression, with anguish. 

Ignatia. — Grief from loss of relatives, fright, disappoint- 
ment. 

Iodine. — Sense of discouragement, want of spirit. 

Mercurius. — Fretful irritability, with nervous tremors. 

Phosphorus. — Nervous exhaustion. 

Platina. — Religious melancholy, and that consequent on 
deranged uterine health ; apprehension of death. 

Pure air, good nourishing diet, cheerful society, refresh- 
ing sleep, change of occupation and scenery, are essential to 
the restoration of the patient. 



390 THEORY AND PRACTICE OF MEDICINE. 

CEPHALAGIA. 

HEADACHE. 

This must not be confounded with neuralgia, reflex symp- 
toms of organic diseases, or inflammatory conditions of the 
brain. There is, however, a reflex action from perverted 
digestion, and hence you will have to remember that fact, or 
you may not be able to remove headache until indigestion is 
overcome. Occupation and habits of the patient must often 
be changed before headache is relieved permanently by your 
remedies. Close application to books often produce headache, 
especially what is called school-girl's headache. 

Treatment. — Aconite. — Sensation as if the brain would 
press through the forehead ; vertigo when rising from a sit- 
ting posture ; bitter bilious vomiting ; gets desperate. 

Arnica. — From falls or bruises ; headache principally over 
the eyes ; head and face hot, while the body is cool ; soreness 
in the stomach, nausea and vomiting. 

Arsenicum. — Periodical headache; beating pain in the 
forehead ; violent vomiting ; pain on top of the head, with 
cold sensation ; extreme thirst, drinking little and often. 

Belladonna. — Violent throbbing pain, especially in the 
forehead, obliging one to close the eyes ; vertigo, with stupe- 
faction and vanishing of sight ; nausea and vomiting of bile, 
mucus or food ; cannot bear noise or bright light. 

Belladonna is the great headache remedy, and when you 
are in doubt as to which remedy to give, let your patient have 
Belladonna. 

Bryonia. — Headache sets in on first waking in the morn- 
ing ; wants to keep perfectly still ; gets faint or sick on sitting 
up ; sour bitter vomiting. 

Cactus. — Pain commencing in the morning and growing 
worse as the day advances ; must lie perfectly quiet, as any 
motion, noise, or light increases the suffering. 

Calcarea carb. — Throbbing headache in the morning, con- 



THEORY AND PRACTICE OF MEDICINE. 39I 

tinuing the whole day ; feeling of coldness in the head ; feet 
cold, as if they had on damp stockings. 

Chamomilla. — Acute shooting or throbbing pains in the 
forehead ; one cheek red and the other pale ; over-sensitive to 
pain, gets almost furious. 

China. — Intense throbbing headache after excessive deple- 
tion; ringing in the ears, and weak faint spells ; worse every 
other day. 

Coffea. — Headache as if a nail were driven into the brain, 
worse in the open air, worse from noise or light ; head feels 
too small ; extreme wakefulness. 

Glonoinum. — Violent throbbing, pulsating headache, with 
fullness and upward pressure in the head ; undulating sensa- 
tion in the head, worse from turning round. 

Ignatia. — Pain as if a nail were driven out through the 
side of the head ; patient full of suppressed grief. 

Ipecac. — Headache as if the brain and skull were bruised 
even to the root of the tongue ; vomiting is a prominent symp- 
tom ; stooping causes vomiting. 

Cimicifuga. — Great pain in head and eye-balls ; increased 
by the slightest movement ; head feels too large and throbs. 

Nux vomica, — Headache with sour, bitter vomiting ; stu- 
pefying headache, especially in the morning, aggravated by 
mental exertion. 

Phosphoric acid. — Dreadful pain on top of the head, as 
though the brain were crushed, after long-continued grief; 
school-girl's headache. 

Pulsatilla. — From eating rich, greasy food ; tearing, draw- 
ing, or stitching pains, worse towards evening; craves cool, 
fresh air, and feels worse in a close, warm room ; chilliness, 
even in a warm room ; she weeps and complains. 

Sa?tguinaria. — Pains in the back part of the head, running 
in rays from the neck upwards, and settles over the right eye, 
with nausea and vomiting ; has to keep in a dark room and lie 
perfectly still. 

Spigelia. — Periodical headache ; pains boring, pressing, 



392 THEORY AND PRACTICE OF MEDICINE. 

increased by motion, noise, and especially by stooping. Nerv- 
ous headache when one or both eyes are involved ; severe stick- 
ing pains in the eyes, worse during motion ; palpitation of the 
heart. 

Sulphur. — Pains mostly in the forehead and temples, press- 
ing, throbbing, or tearing ; constant heat and pain on top of 
the head ; suppressed eruptions ; lean persons who walk 
stooping. 

Veratrum album. — Nervous headache: violent pains, that 
almost deprive the patient of reason ; becomes very weak and 
faint, with cold perspiration all over ; constant heat on top of 
the head : great thirst for cold drinks. 

VERTIGO. 

GIDDINESS. 

This disease is characterized by a swimming or dizzy feel- 
ing in the head ; giddiness means the same thing ; the patient 
often feels like falling, and often does unless supported. They 
may fall forwards, backwards or sidewise. Sometimes there 
is a feeling- as though the couch on which he lies is constantlv 
turning round. 

Causes. — It is often associated with dyspepsia, nervous 
condition, and is often a reflex of brain, heart or kidney 
troubles. 

Prognosis. — Is favorable when not the result of organic 
diseases. Men in middle age, who are perplexed by business 
affairs, are liable to attacks of vertigo. Sometimes it may last 
for years and finally pass off leaving the patient in good health. 
If, however, vertigo is the result of organic diseases then vour 
prognosis must be grave. 

Treatment. — Aconite. — Vertigo from congestion, as in 
the sun ; vertigo on raising the head, especially after lying 
down in a warm room : sometimes the patient reels as if drunk. 

Agaricus. — Vertigo, when walking in the open air ; reel- 
ing as if drunk, long lasting ; head falls backwards. 



THEORY AND PRACTICE OF MEDICINE. 393 

Belladonna. — Cloudiness, as if intoxicated ; blood mounts 
to the head, which becomes heavy as if giddy. 

Bryonia. — Vertigo, as though all objects were reeling ; as 
though the brain were turning around ; as if the head were 
turning in a circle ; on rising, or on raising the head, with 
reeling backwards. 

Cactus. — Vertigo from congestion ; face red, bloated, pul- 
sation in the brain ; madness, anxiety ; heart complications. 

Calcarea carb. — Vertigo when walking in open air, as if 
he would reel, especially when turning the head quickly ; on 
going up stairs ; worse in the morning, with nausea and 
vomiting. 

Coccirius. — Vertigo as from intoxication, or with inclina- 
tion to vomit, when raising up in bed ; must lie down. 

Conium maculatum. — Vertigo like turning in a circle, on 
rising from a seat ; worse when lying down, as though the 
bed were turning in a circle ; when turning in bed or when 
looking around ; from motion downwards ; when walking. 

Digitalis purpurea. — Vertigo when walking or riding; 
with trembling ; very slow pulse. 

Gelsemium. — Vertigo, dim vision, fever ; seems as if in- 
toxicated when trying to move. Child dizzy, when carried 
seizes hold of the nurse, fearing that it will fall. 

Iodine. — Vertigo, only on left side; with throbbing in 
head and all over body, tremor at heart, fainting ; worse im- 
mediately after rising from a seat or bed ; or by sitting or 
lying down after slight exercise. 

Laurocerasus. — Vertigo with disposition to sleep; worse 
in the open air. 

Nux vomica. — Vertigo, with loss of consciousness ; falls for- 
ward when stooping, as if the bed was turning in a circle. 

Phosphoricum acidum. — Vertigo, on closing the eyes it 
seems as if feet arose. 

Veratrum albujn. — Vertigo, with cold sweat on forehead, 
with loss of vision, sudden fainting ; things seem to whirl in 
a circle. 



394 THEORY AND PRACTICE OF MEDICINE. 

CATALEPSIA. 

CATALEPSY. 

This is a rare affection, but lest you might be taken by 
surprise as I was once, I thought best to call your attention 
to the subject. This disease is characterized by a sudden 
spasm or rigidity of the limbs, which remain in any position 
in which they are placed independent of the laws of gravita- 
tion ; that is to say, if you take hold of an arm or a leg of a 
cataleptic and raise them in any position, they will remain in 
the same elevated position in which you place them. I well 
remember the first case I ever saw, or ever heard of at that 
time, for I had never read a word on the subject, prior to that 
case. I was called to see a lady, and when I entered her room 
I found her unconscious and motionless, with one arm ex- 
tended. When I took hold of her hand I found the arm stiff 
and would remain in the same position, whether I raised or 
lowered it. I elevated one of the lower limbs and found that 
it remained where I placed it, irrespective of its weight and 
the force of gravity. Being a good diagnostician, and not 
knowing what to call the disease, I explained it as one of 
those obscure hysterical. affections, which was distressing but 
not dangerous. After a careful study of the limited literature 
on the subject, and finding that the cause is obscure, I have 
come to the conclusion that I was about correct in my hasty 
and forced diagnosis of my case. I now believe that catalepsy 
is a form of hysteria in which the will of the person so con- 
trols the nerves supplying the muscular system as to produce 
that condition called catalepsy. This being true, then the 
will has power to hold the limbs in an elevated position con- 
trary to the laws of gravitation. 

I wish that I was able to carry the investigation further 
and tell you the cause or influence over the will to produce 
that singular condition, but I am sorry to say that I know noth- 
ing about it. One thing, however, I do know, and that is, that 



THEORY AND PRACTICE OF MEDICINE. 395 

crude doses of cannabis indica will produce catalepsy ; and 
hence that remedy is homoeopathic to that disease. 

Treatment. — Cannabis indica. — Cataleptic condition 
of the muscles ; tetanic spasms of the jaws. 

Cicuta virosa, cuprum, and opium may be used to advan- 
tage for any complications that may arise. 

NAUSEA MARINA. 

SEA-SICKNESS. 

This is an affection produced by the motion of a vessel in 
a rough sea. Similar symptoms may be produced in a less 
degree by a railway train, and the motion of a carriage. 

Symptoms. — Dizziness, vertigo, headache, nausea, and 
vomiting are the prominent symptoms, followed by extreme 
physical prostration, and loss of appetite. 

Causes. — It is supposed that the wave-like motion com- 
municated to the brain causes a deficient amount of blood sup- 
ply to that organ. 

Treatment. — Cocculus. — Nausea, which is felt in the 
head ; nausea and vomiting when riding in a carriage or cars. 

Chloralum hydrate. — For sea-sickness. 

Petroleum. — Nausea and vomiting of bitter, green sub- 
stances ; worse from riding in railway carriage. 

Tabacum. — Persistent deathly nausea and vomiting from 
sea-sickness. 

It is said that Petroleum, cocculus, and nux vomica, should 
be given before going aboard of a vessel and cars to prevent sea- 
sickness. Kresotum, tabacum and petroleum, are the best for 
an attack. 

The horizontal position should be assumed and retained if 
possible until the attack is over. It is said that sour, or but- 
terless milk, is a nice relish, and hastens a return to health. 
I think that an attack of sea-sickness may be warded off, or 
modified, by using the colon douche a day or two before start- 



396 THEORY AND PRACTICE OF MEDICINE. 

ing on a journey. Nnx vomica taken several days before em- 
barking on a journey will promote digestion and regulate the 
bowels. 

PARALYSIS. 

PALSY — PARALYTIC STROKE. 

This is a disease which is characterized by loss of motion 
in any part of the body. When sensation is lost with motion 
it is called anaesthesia ; that is, paralysis of the nerves of sen- 
sation. For convenience of description paralysis may be classi- 
fied under the following heads. 1. General paralysis. 2. 
Hemiplegia. 3. Paraplegia. 4. Facial paralysis. 5. Paraly- 
sis agitans. 6. Glosso-L-aryngial. 7. Tabes dorsalis-locomo- 
tor ataxia. 8. Scrivener's palsy. 

Causes. — The general cause of paralysis in different 
forms may be classified thus: 1. Disease of the brain, arising 
from apoplexy, minute hemorrhages, softening, induration, 
tumors. 2. Disease of the spinal cord, arising from inflamma- 
tion, atrophy, renal disease, loss of continuity. 3. Disease of 
the investing membranes, causing pressure on the brain or 
nerve, or simple lesion of the nerve, which impairs its conduct- 
ing power. 4. Epilepsy, chorea, hysteria, diphtheria or rheu- 
matism ; and 5. the influence of poison. 

1. General Paralysis. — This disease may come on sud- 
denly or gradually. It pervades the muscular system in a 
more general way than any of the other varieties. 

This disease is characterized by a pricking or tingling sen- 
sation in the fingers and toes, and gradually extends to the 
whole body. This form of paralysis, however, is rare. 

Treatment. — Belladonna. — Paralytic weakness of all 
the muscles, especially of feet ; if produced by apoplexy. 

Baryta carb. — General paralysis of old people; loss of 
memory, childishness, trembling of the limbs ; after apoplexy ; 
in old age. 



THEORY AND PRACTICE OF MEDICINE. 397 

Cocculns. — Paralysis of face, tongue, or pharynx, para- 
plegia. 

Gelsemium. — Paralysis of motion ; muscles will not obey 
the will ; tingling, pricking, crawling. 

Opium. — Paralysis, insensibility after apoplexy, also in 
drunkards ; old people. 

Phosphorus — Paralysis; formication and tearing in the 
limbs ; anaesthesia. 

Plumbum. — Paralysis ; the parts emaciate ; wrist-drop ; 
caused by apoplexy, sclerosis of the brain or progressive mus- 
cular atrophy. 

2. Hemiplegia. — This disease is characterized by paraly- 
sis of one side of the body, and mostly on the left side. 
Which ever side is affected the opposite side of the brain is in- 
volved. The reason of that is the nerves of motion and sen- 
sation cross each other ; that is from left to right, and vice 
versa, before being distributed to the body. So if the left half 
of the body is paralyzed then you know that the cause is in 
the right side of the brain. The cheek on the affected side 
becomes flabby, the mouth and face are drawn to the sound 
side. When the tongue is protruded it is thrust towards the 
palsied side ; the speech is either lost, or it is thick, mutter- 
ing, and unintelligible. The limbs on the affected side are 
powerless, and if raised fall by their own weight. In rare 
cases the mouth, is drawn to the affected side, and the tongue 
protruded toward the sound side. That is due to the impres- 
sion made on two sets of nerves. Hemiplegia may be only 
partial. In that case but one arm may be affected more than 
the leg. The dropping of the upper eye-lid, called ptosis, is 
due to the slight affection of the third nerve. The mind is 
usually pretty clear, but sometimes it is beclouded. 

Prognosis. — Favorable when the patient is young and 
the paralytic stroke is recent, partial, and incomplete. Un- 
favorable when the shock is severe, perfect loss of power, and 
occurring in advanced life. 



398 THEORY AND PRACTICE OF MEDICINE. 

If anaesthesia has accompanied the shock, and there is a 
tingling sensation returning to the limbs, then your progno- 
sis may be favorable. 

Treatment. — Aconite. — Numbness, tingling ; left side 
lame ; paralysis of the limbs. 

Arjiica. — Paralysis ; generally painful ; left side (after ap- 
oplexy) ; partial, from concussion of the spine. 

Nux vomica. — Paralysis ; parts cold, numb, emaciated ; 
caused by apoplexy or cerebral softening, with vertigo and 
weak memory ; from abuse of alcohol. 

Rhus tox. — Hemiplegia, right sided; sensation as if gone 
to sleep. 

ARAPLEGiA 

This condition is characterized by partial or complete 
paralysis of the lower half of the body. The legs, muscles of 
the rectum and bladder, are more or less affected. This form 
of paralysis is caused by disease of the spinal cord, its mem- 
branes, or of the vertebrae, or any pressure on the cord and 
its meninges. 

There are two kinds of paraplegia — reflex, due to some ex- 
citation of the spinal cord from a sensitive nerve, and associ- 
ated with injury or disease of organs remote from the spinal 
cord ; and myelitic, due to inflammation of the substance of 
the spinal cord. In reflex paralysis, Dr. Brown-Sequard be- 
lieves that the disorder is accompanied and perhaps produced 
by an insufficient supply of blood to the spinal cord. There 
are, however, no special symptoms of organic disease. Dr. 
Meryon, making reference to the proximate causes of the dis- 
order, describes several forms of reflex paralysis, as emotional, 
due to pregnancy ; neurolytic ; from the irritation of worms ; 
from the irritation of teething ; urinary ; from uterine dis- 
eases ; and from mechanical injury. The importance of 
observing these distinctions is that the practitioner may ap- 
ply remedial measures to the proximate cause of the palsy, if 



THEORY AND PRACTICE OF MEDICINE. 399 

he hopes to relieve the consequent disorder. If, instead of 
diminishing nutrition of the cord, there be increase in the 
amount of blood, as in chronic local myelitis, causing con- 
gestion or inflammation of the cord or its membranes, then 
this special condition will demand particular attention. Its 
symptoms are convulsions, cramps, twitchings, and other in- 
dications of irritation of nerve fibers. 

Paraplegia is slow and insidious in its manifestations. 
There is numbness and tingling in the toes and feet. There 
is paralysis of the bladder and rectum, the urine becomes alka- 
line and fetid. 

Prognosis. — If the disease is brought on by cold, intem- 
perance, or self-abuse, then the prognosis will be favorable. 
But if caused by disease of the spinal cord or brain then it is 
grave. 

Treatment. — Argentum nitricum. — Paraplegia from 
debilitating causes. 

Caidophylliim. — Paraplegia, with retroversion and conges- 
tion of the uterus after child-birth ; partial loss of sensation ; 
emaciation, anaemia, general debility. 

Cocculus. — Paralysis of face, tongue or pharynx, paraplegia. 

Conium maculatum. — Muscular paralysis with spasms. 

Phosphorus. — Paralysis ; formication and tearing in the 
limbs ; anaesthesia. 

Rhus tox. — Paralysis ; after unwonted exertion ; rheuma- 
tic, from getting wet, or lying on damp ground. 

Strychnia or nux vomita. — Paralysis; parts cold, numb, 
emaciated ; caused by apoplexy or cerebral softening, with 
vertigo and weak memory. 

Veratrum viride. — Paralysis ; tingling in limbs ; cerebral 
hyperaemia. 

Facial Paralysis. — Paralysis on one side of the face. 

Treatment. — Causticum. 

Ignatia. — Paralysis after great mental emotion and night- 
watching in sick-chamber. 



400 THEORY AND PRACTICE OF MEDICINE. 

Ptosis. — This has reference to paralysis of the eye-lid. 

Treatment. — Gelsemium. — Paralysis of the muscles of 
the eye ; of the upper lid and of the proper muscles of the 
eye-ball. 

Paralysis Agitans. — This complaint is the well-known 
disease, shaking palsy. 

Treatment. — Mercurius. — Paralysis agitans. 
Hyoscyamus. — Paralysis after spasms. 
Tarantula. — Paralysis agitans. 

Glosso-Laryngial Paralysis. — This is an affection 
characterized by paralysis of the tongue and larynx. 

Treatment. — Causticum. — Speechlessness from paral- 
ysis of the organs of speech. The laryngeal muscles refuse 
their service ; cannot speak a word aloud. 

Belladonna. — Paralytic weakness of organs of speech. 

Hyoscyamus niger. — Paralysis of the tongue. 

Gelsemium. — Tongue and glottis partially paralyzed ; par- 
alyis of the glottis. 

Scrivener's Palsy. — This is a paralysis of the fingers 
and thumb, in which the controlling or co-ordinating power 
of the hand is lost, which prevents writing, sewing, paint- 
ing, etc. 

The first indication is a tired feeling of the hand when 
writing, and often reaches that stage when the hand becomes 
powerless. 

Causes. — The constant use of the hand by writers, 
painters, etc. 

Treatment. — Arnica. — Arm weary as if bruised, so that 
he could not bend his fingers inward ; when writing the pain is 
felt especially in dorsum of hand ; letting the arm hang down. 

Rhus tox. — Index and middle finger asleep in the morning. 

Nux Vomica. — Lameness and stiffness of right wrist and 
hand ; no power to write ; hand falls to sleep. 



THEORY AND PRACTICE OF MEDICINE. 401 

TABES DORSALIS. 

LOCOMOTOR ATAXIA. 

This disease is attended with loss of power of co-ordinating 
movements, causing unsteadiness of gait; there may be perfect 
muscular power, but progressive loss of voluntary and instinc- 
tive controlling power. The symptoms may be arranged in 
three series. 1st, Temporary loss of power in one of the 
motor nerves of the eye, disordered vision, paroxysms of neu- 
ralgic pain, impotence. 2d. Difficulty in standing or walking 
with steadiness, loss of sensibility, incontinence of urine, con- 
stipation. 3d. All preceding symptoms are aggravated, and 
loss of power becomes general. 

Cause. — Disease of the posterior columns of the spinal 
cord is the cause of locomotor ataxia. 

Pathology. — The whole cord is affected, the pia and 
dura mater become thickened and adherent, and the whole 
cord becomes atrophied. 

Diagnosis. — If you are not on your guard you may mis- 
take this disease for paraplegia. Paraplegia is a true paraly- 
sis, ataxia is not ; and it is readily proved that in the latter 
disease muscular force is not diminished. In paraplegia the 
limbs are not thrown about in walking — they are merely 
dragged. In paraplegia there is little or no resistance to artifi- 
cial movement, while in ataxia there is great resistance in bend- 
ing the limbs against the will of the patient. The nutrition 
of the muscles is markedly impaired in paraplegia, and normal 
in ataxia. Neuralgic pains are absent in paraplegia and pres- 
ent in ataxia. 

You must not lose sight of the fact that the inability to 
control the limbs is not unfrequently the consequence of severe 
cerebral diseases, of fevers, of poisoning by belladonna, tobacco, 
alcohol, etc. 

Prognosis. — Very unfavorable, cure rare ; but life may 
be prolonged many years. 

25 



402 THEORY AND PRACTICE OF MEDICINE. 

Treatment. — Argentum nitricum. — Voluntary motion 
impossible ; left side indescribably weak. 

Bellado7iiia. — Hypersemia of spine, with difficulty in walk- 
ing, loss of co-ordination when walking. 

Phosphorus. — Progressive locomotor ataxia, 
Local Applications. — Electricity judiciously applied is 
often beneficial in some forms of paralysis. But it must be 
applied in very mild currents, or it may do more harm than 
good. In my hands the horse-radish has surpassed electricity 
and all other external applications, especially in infantile para- 
lysis. I tried an experiment on an old lady sixty years of age 
with hemiplegia. I gave her no medicine, but had her bathed 
twice a day with a solution of horse-radish. She recovered 
and could walk as good as ever. I had horse-radish root 
grated fine, and a tea-cup full to a quart of water ; the whole 
spine and paralyzed side was bathed night and morning with 
the solution. Sea-bathing, with steady friction is sometimes 
very beneficial 

APOPLEXIA 

APOPLEXY. 

There are three species of this disease, i. Simple or con- 
gestive apoplexy ; congestion of the vessels of the brain with- 
out rupture. 2. Hemorrhagic apoplexy, or congestion with 
rupture. 3. Serous apoplexy, or congestion with serous 
effusion. 

Symptoms. — 1. Sometimes the patient is seized sud- 
denly, falling down without warning. 2. After a short pre- 
monitory stage, consisting of acute headache, sickness and 
faintness. 3. With sudden hemiplegia. In all of the forms 
the fit is characterized by complete insensibility, accompanied 
by slow and noisy, or stertorous and puffing breathing ; im- 
peded deglutition ; flushed and livid countenance ; prominent 
and motionless eye, with (generally) a contracted pupil ; the 
limbs are either motionless or rigid, or convulsed, or these 



THEORY AND PRACTICE OF MEDICINE. 403 

several states exist on one side, or in one limb, and not on the 
other or in the rest. The bowels are either obstinately con- 
fined, or the evacuations are passed involuntarily ; the urine 
also is either passed involuntarily, or being retained till the 
bladder is full, dribbles away. The pulse is full, strong, and 
quick, but sometimes more and sometimes less frequent than 
natural. Vertigo, headache, confusion of ideas, incoherence, 
loss of memory, faltering speech, drowsiness, numbness of the 
extremities, pallor, nausea, vomiting, and faintness are often 
forerunners of apoplexy. 

Apoplexy may end suddenly in death, or it may last for an 
indefinite period, and finally the patient may recover. 

Causes. — Predisposing. — From the fifteenth to the 
eightieth year, the liability increases as the age advances. 
Few cases occur under twenty, and very few indeed in child- 
hood. A short thick neck, large chest, and stout persons, are 
more liable to attacks. Metastasis of rheumatism, and other 
diseases may be a predisposing cause. 

Exciting. — Violent exercise, singing and playing on wind 
instruments ; extreme heat or cold, opium, alcohol, and nar- 
cotic poisons. 

Prognosis. — Favorable. — Youth ; the function of res- 
piration not much affected ; hemorrhage from the nose or 
hemorrhoidal vessels. 

Unfavorable. — Protracted beyond the third day; in- 
creased frequency of the pulse from the first, or after an inter- 
val ; retention of urine ; cold extremities ; cold and clammy 
sweat. 

Pathology, — In congestive or simple apoplexy, disten- 
tion of the veins of the brain, with or without effusion into the 
ventricles, or at the base of the brain. In the hemorrhagic 
apoplexy, effusion of blood in the substance of the brain, into 
the ventricles, at the base, or on the surface ; in serous apo- 
plexy, effusion of serum in the ventricles, or under the arach- 
noid, on the surface, or at the base of the brain. 

Diagnosis. — From the effect of spirituous liquors, by 



404 THEORY AND PRACTICE OF MEDICINE. 

the odor of the breath ; from the effect of narcotic poisons, by 
the history of the case. In narcotic poisoning the patient can 
be aroused for a short time. 

Epilepsy begins with a scream, is always attended by con- 
vulsions, and much frothing at the mouth ; symptoms which 
do not occur in apoplexy. 

Treatment. — Aconite. — Full, rapid, and strong pulse ; 
dry, hot skin ; paralysis of the tongue, with trembling, stam- 
mering speech ; great difficulty in swallowing. 

Arnica. — When the patient has sustained an injury about 
the head ; active congestion in old people, threatening san- 
guineous apoplexv. 

Baryta carb. — Apoplexy of aged persons, and those of in- 
temperate habits ; paralysis of the limbs, right (left side lache- 
sis) ; disturbed consciousness, with childish gesticulations. 

Belladonna. — Red, swollen face, throbbing of the blood 
vessels, convulsive movements of the face or limbs, dilatation 
of the pupils, loss of speech, suppression or involuntary dis- 
charge of urine. 

Cactus. — Weight on vertex, or pressure on right side of 
the head. 

Cocculus. — Stupid feeling in the head, and vertigo pre- 
ceding the paroxysm. Paralysis, especially the lower limbs. 

Gelsemium. — Intense passive congestion, with nervous 
exhaustion. 

Hydrocyanic acid. — The eyes fixed and turned upwards, 
breathing stertorous, and pulse almost imperceptible ; par- 
alysis of the esophagus ; fluids pass down into the stomach 
with a gurgling sound. 

Hyoscyamus. — Sudden falling down, with a shriek ; loss 
of consciousness and of speech ; foam at the mouth ; paralysis 
of the bladder and sphincter ani ; twitching and jerking of all 
the muscles. 

Lachesis. — Apoplexy with paralysis of the left side, and 
coldness of the hands as if dead ; mouth drawn to one side ; 
can not bear anything to touch his neck. 



THEORY AND PRACTICE OF MEDICINE. 405 

Laurocerasus. — Sudden attack of apoplexy, where the pa- 
tient falls down without any precursory symptoms ; eyes star- 
ing, or lightly closed ; pupils dilated, or contracted and im- 
movable ; low, feeble moaning, or rattling breathing. 

Nux vomica. — The paroxysm is preceded by vertigo with 
headache and buzzing in the ears, or nausea with vomiting ; 
stupefaction, with stertorous- breathing ; paralysis of the lower 
jaw, and often the lower extremities, which are cold and 
without sensation. 

Opium. — Drowsiness, cerebritis, stupor or profound coma ; 
slow, full pulse ; stertorous and irregular breathing ; bloated 
face, stupid and besotted expression, half-open eyes, con- 
tracted pupils ; cold extremities. 

Phosphorus. — This remedy is supposed to retard or correct 
the calcareous degeneration of the arterial blood-vessels. 

During the fit the patient .should be placed in a large room 
where there is a constant supply of cool air. You should 
loosen all clothing about his waist and neck ; warm bottles 
should be placed at his feet and around his limbs, cover up 
warm ; apply a rubber cap to the head containing crushed ice. 
Sometimes a sinapism applied to the epigastrium or along the 
spine, acts as a counter-irritant, and thus has a tendency to 
draw the attraction from the brain. 

EPILEPSIA— EPILEPSY. 

FALLING SICKNESS — FITS. 

Symptoms. — Sudden loss of sense and power of mo- 
tion ; the patient gives a peculiar, loud, piercing cry as he 
falls in convulsions. The whole body becomes convulsed ; 
the hands are clinched and the arms tossed about ; the breath- 
ing is laborious, a bloody foam issues from the mouth ; the 
tongue and lips are often bitten. The convulsive movements 
last for several hours, when the patient passes into a quiet 
slumber, after which he is able to continue about his avoca- 
tion. This form of epilepsy the French call grand mal, in 



406 THEORY AND PRACTICE OF MEDICINE. 

contradistinction to a milder form, which they call petit mal. 
This form is preceded by giddiness, confusion of mind, un- 
steadiness, with loss of consciousness, and sometimes only 
slight convulsions. 

The patient is sometimes warned of the approach of an 
attack by the sensation as if insects were creeping over the 
body, or as if cold or warm water was running over him. 
This is called the aura epileptica, and when present gives the 
individual time to reach a place of safety. 

Causes. — Hereditary taint, dissipation, intemperance 
and everything that has a tendency to produce nervous pros- 
tration. 

Diagnosis. — Patient wholly unconscious, pulse ex- 
cited ; while in hysteria the pulse is normal and patient is 
conscious. In feigned epilepsy there is no loss of sensation, 
while in epilepsy there is a total loss of sensation even of the 
retina. Apoplexy has stertorous breathing, and partial par- 
alysis. 

Prognosis. — If epilepsy comes on before puberty and is 
not hereditary, then it is often curable. If, however, it oc- 
curs after puberty, and is hereditary, the chances of cure are 
unfavorable. 

Treatment. — It is supposed, that the inhalation of 
nitrate of amy I will prevent the attack. It is advisable for 
an epileptic to carry with him constantly a vial containing a 
sponge saturated with the medicine, and as soon as he feels 
the least symptom of the approach of the disease to open the 
vial and inhale the fumes. 

Artemisia vulgaris. — Fits recurring at intervals varying 
from three to five weeks ; lanceration of the tongue ; dilata- 
tion of one pupil ; picking with the fingers. 

Belladonna. — Spasmodic motions of the body ; convul- 
sions commencing in arm. 

Calcarea carb. — Before the attack, sense of something run- 
ning in the arm, or from the pit of the stomach down through 
the abdomen into the feet. 



THEORY AND PRACTICE OF MEDICINE. 407 

Cicuta virosa. — Epileptical attacks ; screaming, loss of 
consciousness. 

Cuprum metallicum. — Epileptic convulsions ; trembling, 
tottering and falling unconscious without a scream ; preceded 
by drawing in left arm ; aura epileptica ; with froth at the 
mouth, opisthotonos ; limbs abducted. 

Hyoscyamus. — Before the attack ; vertigo, sparks before 
eyes, ringiug in ears, shrieks, grinding teeth. 

Ignatia. — Convulsions, with frothing at the mouth. 

Kali bromicum. — Dr. Maffey says that he once saw a per- 
son take ninety grains of bromide of potash at one dose, and it 
produced symptoms resembling an epileptic fit. This being 
true, it shows the drug to be homoeopathic to epilepsy. It is 
a favorable remedy with the old-school, but they give too much. 

Laurocerasus. — Epileptic convulsions. 

Nux vomica. — Convulsions beginning with an aura ; spasm 
begins with loud screams ; then foam at mouth. 

Plumbum. — Chronic form ; before the spell, legs heavy 
and numb, tongue swollen. 

Strammonium. — Epilepsy from fright ; attacks sudden, 
with screams, afterwards drowsy. 

Sulphur. — Epilepsy with stiffness ; a sensation like from 
a mouse running up arms to back before the fit. 

Argentum metallicum, and nitricum, have been recom- 
mended for epileptic attacks, followed by delirious rage, and 
epilepsy from fright. 

The patient's surroundings and mode of living should be 
looked after, and everything that tends to excite the nervous 
system should be avoided. The diet should be nourishing 
and unstimulating. 

CHOREA SANCTI VITI. 

ST. VITUS'S DANCE. 

The term chorea comes from choreia, a dance, and was 
called St. Vitus's dance, from the fact that those afflicted with 



408 THEORY AND PRACTICE OF MEDICINE. 

the malady, flocked to the shrine of St. Vitus, where they 
hoped to be cured by a miracle. The disease is caused by a 
functional derangement of the motor nerves, and the peculiar 
convulsive twitchings of the muscles and limbs, have caused 
some to term it insanity of the voluntary muscles. 

Symptoms. — The disease usually begins in the left 
arm, by slight twitchings and turning of the hand ; it may re- 
main in one limb, but usually it involves the whole body ; as 
the disease advances the patient is unable to feed himself ; in 
attempting to do so his hand will jerk past his mouth, and 
often if he attempts to take a drink of water he lets the glass 
fall. In walking the lower limbs have a dragging or jerking 
movement. The mouth and eyes often become distorted. 
Sometimes there is only a jerking of the muscles of the face, 
and the head may be tossed from side to side, or backward. 
The choreic movements cease during sleep. 

Causes. — There may be a hereditary tendency, or it may 
be acquired by irritation of the stomach and bowels by fright 
or any thing that will produce nervous irritation. Girls are 
more liable to attacks than boys. The disease usually oc- 
curs between the ages of five and twenty years, but may occur 
at any period of life. It is said that the pure-blooded negro 
is exempt. 

Prognosis. — Is favorable. I never knew any one to die 
of it. It might prove fatal in a broken-down constitution. 

Diagnosis. — I know of no disease that might be mis- 
taken for it. Some boys get into the habit of twitching the 
muscles of the eye and mouth, and jerking of the head, that 
may be mistaken for chronic symptoms. If the habit is 
noticed early, it may be broken up, but medicine can have 
but little effect upon it. 

Treatment. — Rest and quiet are of the first import- 
ance, and mental excitement should be avoided. 

Homoeopathy has gained some of its greatest triumphs in 
the speedy cure of choretic patients. The following are the 
remedies in which I place most reliance. 



THEORY AND PRACTICE OF MEDICINE. 409 

Aconite. — Jerking of the left leg or arm, twitching of 
single muscles. 

Agaricus. — Simple involuntary motions and jerks of 
single muscles, to a dancing of the whole body ; involuntary 
movements while awake ; ceasing during sleep. 

Belladonna. — Weakness and tottering gait. Muscles of 
face, jaw and limbs, agitated by convulsive twitchings. 

Causticum. — Chorea even at night, right side of face and 
tongue may be paralyzed. 

Cimicifuga. — Trembling of the legs, twitching of the 
flexors ; irregular motion of the limbs, worse left ; legs un- 
steady. 

Cina. — If chorea is induced by worms, then cina is a valu- 
able remedy ; twitching, jerking and distortion of the limbs. 

Cuprum metallicum. — Nervous trembling, twitching of the 
limbs. 

Hyoscyamus. — Throws arms about, misses what is reached 
for ; gait tottering ; angular motions ; jerks of single muscles 
or sets of muscles. 

Ignatia. — Trembling of the limbs ; convulsive twitchings, 
especially after fright or grief. 

Mygale. — Dr. J. G. Houard gives the following provings 
of this drug. Muscles of the face twitch ; mouth and eyes 
open and close in rapid succession ; can not put the hand to 
the face, it is arrested midway and jerked down ; gait unsteady ; 
legs in motion while sitting, and dragged while attempting to 
walk ; constant motion of the whole body. 

Spigelia. — Restless ; can not keep limbs still at night. 

Tarantula. — Chorea, especially of the extremities; noc- 
turnal chorea in children. 

Veratrum viride. — Cerebral complications, trembling, and 
jerking of the limbs. 

Zincum. — Twitchings in various muscles ; the whole body 
jerks, during sleep ; chorea, caused by fright. 

All exciting causes should be avoided, and the patient kept 
quiet as possible. 



4-IO THEORY AND PRACTICE OF MEDICINE. 

TETANUS. 

LOCK-JAW. 

This disease is characterized by spasm of the voluntary 
muscles. There are two varieties ; idiopathic from general 
causes, and traumatic, from wounds. A prolific cause of trau- 
matic tetanus is the Fourth of July toy pistol. 

Symptoms. — The following from Hooper's Vade-me- 
cum coincides better with my experience than any thing I 
can say on the subject. " Sense of stiffness in the back part 
of the neck, rendering the motion of the head difficult and 
painful ; difficulty in swallowing ; pain, often violent, re- 
ferred to the sternum, and thence shooting to the back ; spasm 
of the muscles of the neck, pulling the head strongly back- 
ward ; rigidity of the lower jaw, which increasing, the teeth 
become so closely set together as not to admit of the smallest 
opening, when the affection is called trismus or lock-jaw." 

If the disease proceed further, it soon involves the muscles 
of the trunk and spine, so that the whole body is bent forcibly 
backward — opisthotonos; or forward — emprosthotonos ; or 
to the side — pleurothotonos. Duration of the disease is from 
four to eight days. Some cases have died within a few hours. 

Prognosis. — Very unfavorable, more favorable in idio- 
pathic than traumatic. 

Treatment. — Aconite is one of our most reliable rem- 
edies when fever is present. It is said that aco7iite can pro- 
duce spasms closely resembling those of tetanus. It causes 
trismus, stiffness of the limbs and opisthotonos. 

Belladonna. — Throws body forward and backwards while 
lying ; like constant change from emprosthotonos to opis- 
thotonos. 

Cicuta virosa. — Convulsions, with opisthotonos ; frightful 
distortion of whole body. 

Hypericum. — Hering says: "It prevents lock-jaw from 
wounds in soles, fingers, or palms of hands." 



THEORY AND PRACTICE OF MEDICINE. 411 

Physostigma. — Traumatic tetanus, congestion of spinal 
cord, tetanic spasms. 

Bromide of potash, nicotinnm, picrotoxin, passijlora incar- 
nata, hydrocyanic acid, and strychiiia, all have more or less in- 
fluence in lock-jaw. 

HYDROPHOBIA. 

RABIES. 

Rabies or canine madness, is produced by the bite of a 
mad dog. The period of incubation is from a few weeks to 
one or two years. 

Symptoms. — Erichson arranges the symptoms under 
three heads: 1. Spasmodic affection of the muscles of the 
throat and chest ; the act of swallowing, commonly exciting 
convulsions, makes the patient afraid to repeat the attempt ; 
hence the horror of all liquids is so remarkable a feature of the 
disease. 2. An extreme degree of sensibility of the surface of 
the body. 3. Mental agitation and terror frequently mark the 
disease throughout. After a few hours or days, wandering 
pains are felt in different parts of the body, the patient com- 
plains of stiffness of the neck and throat, and is restless, irri- 
table, and drowsy, his sleep is disturbed with frightful dreams. 
The sufferer often screams violently, and talks in a loud, im- 
portant, and authoritative tone ; spits out the viscid saliva be- 
tween his closed teeth, with loud and noisy strainings, not 
unlike the barking of a dog. Duration of the disease is from 
two to eight days. 

Treatment. — Immediate sucking of the wound and 
cauterizing with nitrate of silver, carbolic acid, and nitric acid, 
and the actual cautery are recommended by all authors. 

While I have never tried it, but my experience with iodine 
in the bite from rattlesnakes, induces me to believe that the 
application of the compound tincture of iodine, after the parts 
have been well sucked, and a hypodermic injection of an aque- 
ous solution of iodine and iodide of potash, would give the best 
show for recovery. 



412 THEORY AND PRACTICE OF MEDICINE. 

Belladonna, according to Hahnemann, is the most sure pre- 
ventive. Hempel, in his materia medica, says that several 
cases of genuine rabies have been cured by this remedy. 

Dr. Hale, says that scuttellaria is homoeopathic, and cases 
have been cured by it. 

A peculiar sponge- stone found in some portions of the 
United States called the mad-stone, is said to have cured many 
cases, by soaking it in milk and applying it to the bite. 

Pasteur claimed to cure and prevent rabies by the hypoder- 
mic injection of his anti-rabies serum. 



HYSTERIA. 

HYSTERICS. 

This is a singular functional nervous affection peculiar to 
women, but may occur in men. 

Symptoms. — The patient is of a nervous temperament, 
easily excited to tears and melancholy. Disappointment, or 
imaginary rebuke or unexpected news, is liable to throw her 
into convulsions, preceded by screams, when she falls to the 
ground. She is conscious, pulse is normal, and eyes natural. 
The patient may burst into fits of laughter, sobbing or scream- 
ing. She often complains of a ball rolling in bowels, which 
rises until it reaches the throat, this is called globus hysteri- 
cus. The patient often imagines that she has all of the dis- 
eases to which flesh is heir, and as she is driven from one she 
lays hold of another. 

Causes. — Anything that disturbs the mental faculties 
and nervous centers. 

Diagnosis. — In hysteria the convulsive motions are con- 
trolled by a strong effort of attention ; trembling of the eye-lids. 
In epilepsy the patient has no control, as the convulsions are 
involuntary, and patient is entirely unconscious. The coun- 
tenance is distorted, and the pupils are dilated, while in hys- 
teria they are normal. 



THEORY AND PRACTICE OF MEDICINE. 413 

Prognosis. — Is always favorable when there is no or- 
ganic complication. When males are affected there is some 
danger of future unsoundness of mind. 

Treatment. — If women could be impressed with the 
fact that hysteria is a nervous disease over which the will can 
exert a wonderful influence in warding off the tendency, then 
with proper treatment the disease may at last be eradicated 
from the system. But, on the other hand, if the causes are 
nursed then medicines can only give temporary relief. A 
change of climate and surroundings are sometimes very bene- 
ficial. 

During the fit camphor and moschus by olfaction is suffi- 
cient to quiet the patient. When she arouses then one of the 
following remedies must be given, according to symptoms then 
present. 

Asafcetida. — Burning dryness, or sensation of a ball rising 
in the throat ; spasms, cramping pains, or distended abdomen ; 
nausea and inclination to vomit. 

Aurum metallicum. — Excessive menstrual discharge, con- 
gestive headache, melancholy. 

Causticum. — Loss of voice, profuse flow of urine. 

Cimicifuga. — Uterine disturbance, restlessness, pain in the 
left side under the breast. 

Coffea. — Nervous excitability ; can not sleep. 

Ignatia. — Sensation of a ball in the throat, suffocative 
constrictive sensation, and difficult swallowing ; tearful mood ; 
hysteria from disappointment and grief. 

Moschus. — Small fluttering pulse, with faint feeling. 

Platina. — Depression of spirits ; anxiety ; contemptuous- 
ness ; irritability, and uterine disorders. 

Pulsatilla. — Tearful women with suppressed period or 
uterine disorder. 

Valeriana. — Dread of being left alone ; over-excitability, 
especial dread of the dark or being left alone ; very restless 
and excitable ; globus hystericus, with sensation of something 
warm rising from the stomach into the throat. 



414 THEORY AND PRACTICE OP MEDICINE. 

Zincum. — Nervous excitability ; globus hystericus, rising 
from pit of the stomach. 

If brain or mental symptoms should arise, then belladonna, 
gelsemium and hyoscyamus must be given. In a word, when 
any organ becomes the seat of nervous excitability, the cause 
must be sought and removed. 



INFANTILE CONVULSIONS. 

FITS OF INFANTS. 

Infantile convulsions are, as a rule, due to nervous excita- 
bility, but may be the forerunner of meningitis. 

Symptoms. — The child is fretful, and the muscles of 
the face are seen to twitch before the convulsions appear. 
Sometimes, however, the child is suddenly seized with con- 
vulsions without any observable warnings. During the fit 
the whole body is convulsed, the hands are clenched, the 
thumbs turned inwards, the feet are turned together and great 
toe bent ; the head is jerked sidewise and backward, and at 
each convulsive movement there is a peculiar choking noise. 
The face may be red or pale, the lips livid, breathing difficult 
and often froth issues from the mouth. The fit may last from 
a few minutes to several hours and entirely pass off, or may 
return from time to time until arrested by treatment. 

Causes. — Teething, indigestion, irritation of stomach 
and bowels, fever and everything that produces nervous irri- 
tation in any organ or tissue. 

Diagnosis. — The only thing to diagnose is the cause of 
the convulsion ; that is to say, are the convulsions due to 
simple nervous irritation, or to inflammation of the brain ? If 
the latter, the head and face are hot and red, with rapid pulse, 
and there is more or less paralysis of one arm or leg, or both. 
Prognosis. — Simple irritative convulsions are rarely fatal. 
The only alarming feature to settle is the convulsion, the re- 
sult of nervous excitability or from meningitis. 



THEORY AND PRACTICE OF MEDICINE. 415 

Treatment. — While the child is in a fit its feet and legs 
may be put into a tub of warm water, and at the same time a 
towel wet in cold water should be applied to the head. I think 
it unwise to place the child's whole body in warm water, the 
relaxation is too sudden, and children have been known to die 
in the warm bath. 

As the patient can not swallow, and there is danger of con- 
gestion of the brain or lungs from the powerful convulsions, I 
do not hesitate to drop a few drops of chloroform on a napkin, 
and let the child take a few inhalations from time to time until 
the spasms are arrested, which only takes a few seconds or 
minutes. It is free from danger when given gradually, and 
withdrawn as the muscles begin to relax. After a long ex- 
perience I have never seen bad results, even when given to 
very young infants. It requires care in its administration. 
As soon as the child can swallow, one of the following reme- 
dies should be used. 

Aconite should be given if fever follows the fit, or if the 
child grinds the teeth and has convulsive hiccough. 

If a child has a spasm after a fall then arnica should always 
be given. 

Belladonna. — This is the first remedy to be thought of if 
there is a tendency to the brain with red eyes and face, the 
child is restless, can not sleep, or jumping during sleep. 

Chamomilla. — The child is fretful except when carried, 
one cheek red, and the other pale. 

Cicuta. — The child suddenly becomes stiff, with fixed eyes, 
head bent backward or forward. 

Cina. — Picking and boring at the nose ; there seems to be 
something in the throat which causes frequent swallowing. 

Cuprum. — The child turns and twists in all directions 
after the fit is over. 

Gelsemium. — Nervous excitability with tendency to the 
brain ; sudden loud outcries as the spasm comes on. 

Hyoscyamus. — Starting, twitching of muscles of face and 
eyes even during sleep. 



41 6 THEORY AND PRACTICE OF MEDICINE. 

Ignatia. — Sudden starting from a light sleep, with loud 
screaming and trembling all over ; spasms return about the 
same hour every day, or every other day. 

I once visited a child in the second spasm before I gained 
the correct symptoms to indicate the remedy. While I was 
watching the action of the child, it developed a perfect pic- 
ture of ignatia, and hence it cured the case. When we fail to 
cure a curable case, we must confess that we have been un- 
able to select the indicated remedy. The fault is in us, and 
not in homoeopathy. 

Opium. — Fright followed by loud screaming and spasms. 
The face dark-red, hot and swollen ; stertorous breathing, and 
stupor. 

Sir ammonium. — Tossing of the limbs, and involuntary 
evacuations of feces and urine ; child awakens with a shrink- 
ing look. 

Veratrum viride. — Nausea and tendency to head symp- 
toms ; trembling, as if child was frightened, and on verge of a 
spasm ; convulsions, with opisthotonos. 

Zincum. — Twitchings in various muscles ; the whole body 
jerks during sleep, the child rolls its head from side to side 
when it awakes ; it cries out during sleep and seems frightened. 

If the child is costive it should have an injection of warm 
water. 

When there is an objection to administering cholorofor?n 
by inhalation, I have seen immediate relief by applying it 
along the spine ; half a drachm of chloroform to an ounce of 
olive oil, may be shaken well and applied along the spine. 

If nursing mothers become overheated or excited, then they 
should not nurse their babes until they have become perfectly 
quiet, or else they may cause convulsions in their children ; 
if a child is laid on its left side it often terminates a spasm. 



THEORY AND PRACTICE OF MEDICINE. 417 

ENCEPHALITIS— CEREBRITIS. 

INFLAMMATION OF THE BRAIN. 

Symptoms. — This disease usually manifests itself by 
dull headache, vomiting and constipation. The head is hot, 
pupils of the eyes first contract, but when effusion sets in they 
dilate. Delirium is usually present, the head rolls from side 
to side, and grating of the teeth, the urine is retained, coma- 
sets in and often carries off the patient. 

Prognosis. — Always unfavorable. 

Diagnosis. — The following is the table of Dr. Tanner: 

Cerebral Vomiting. Gastric or Hepatic Vomiting. 

1. Little or no nausea, and the 1. The nausea is relieved, at all 

vomiting continues in spite events temporarily, by the 

of the discharge of con- discharge. It returns di- 

tents of stomach. rectly as food is taken. 

2. No tenderness over liver or 2. Tenderness over the liver 

stomach. Pressure borne and stomach. Pressure in- 

without inconvenience. duces the inclination to 

retch. 

3. The pulse is infrequent and 3. Pulse is frequent and weak. 

hard. 

4. Tongue clean ; breath sweet ; 4. Tongue furred ; breath offen- 

conjunctivae colorless or in- sive ; conjunctivae often 

jected, and headache pri- yellowish ; and headache 

mary. secondary as to time. 

5. Generally obstinate constipa- 5. Griping abdominal pain, di- 

tion. arrhea and clay-colored 

stools. 

6. Stomach emptied without ef- 6. Retching and increased sali- 

fort, no salivation. vation. 

Treatment. — Aconite is usually the first remedy to be 
given, both for fever, pain in head and vomiting. 

Belladonna. — Headache, red eyes, restless jerking and start- 
ing. When belladonna failed to give relief, I have seen good 
results follow the 3X of atropia. Belladonna is, par excellence, 
a head remedy. As a rule I rely more on belladonna, gelse- 
mium, opium and veratrum viride, for inflammation of the 



41 8 THEORY AND PRACTICE OF MEDICINE. 

brain, and its meninges. Crude opium is a powerful conges- 
ter of the brain, and hence to overcome that condition it is 
only safe to use it in 30X or higher. 

The head should be sponged with cold water, or apply the 
ice cap. 

CONCUSSION OF THE BRAIN. 

This is a stunning sensation, produced on the brain by a 
blow or fall on the head. 

Symptoms. — In the mild condition the patient lies 
motionless, unconscious, and insensible ; he is easily aroused, 
but instantly relapses into insensibility, at length he is seen to 
move his limbs and vomits, and rallies quickly. In the more 
severe shock the patient is insensible, the skin is pale and 
cold, the features ghastly, the pulse feeble, and intermittent, 
the breathing slow or performed only by a feeble sigh. Vomit- 
ing is a favorable symptom, showing a return of vitality. 

Treatment. — If there is a fracture it requires the ser- 
vices of a surgeon. 

Arnica. — This remedy should be given at once. 

Aconite, if fever develops. 

Belladonna, for red face and eyes, and pain in the head. 

MYELITIS. 

INFLAMMATION OF THE SPINAL CORD. 

Symptoms. — This affection is either acute or chronic, 
but the latter is by far the most common. The chronic form 
begins with a little uneasiness in the spine, somewhat dis- 
ordered sensations in the extremities, and unusual fatigue 
after any slight exertion. After a short time paralytic symp- 
toms appear, and slowly increase ; the gait becomes uncertain 
and tottering, and at .length the limbs fail to support the 
body. The paralysis finally attacks the bladder and rectum 
and the evacuations are discharged involuntarily ; death takes 



THEORY AND PRACTICE OF MEDICINE. 419 

place as the result of exhaustion, or occasionally of asphyxia, 
if the paralysis involves the chest. In the acute form there is 
much pain, especially in the spinal region, which usually 
ceases when paralysis supervenes. The other symptoms are 
the same as those of the chronic form, but they occur more 
rapidly and with greater severity, and death sometimes takes 
place in a few days. The most common causes of this disease 
are falls, blows and strains from over-exertion, but self -abuse, 
and intemperate habits occasionally induce it. 

Treatment. — If from falls or blows, arnica is the in- 
dicated remedy ; if from strains, then rhus tox. must be given. 
Some of the remedies mentioned under the head of spinal men- 
ingitis may be indicated. 

I have seen good results from wearing a belladonna plaster 
on the spine; or an application of the iodine liniment as al- 
ready referred to allays irritation and pain, and prevents the 
accumulation of fluids within the cord, and causes its reab- 
sorption if it is already there. 

MENINGITIS. 

This is an inflammation of the meninges or sheaths of the 
brain and spinal cord, and is thus classified. 

(Cerebral Meningitis. 
Meningitis \ Cerebro-Spinal Meningitis. 
[_ Spinal Meningitis. 

Cerebral Meningitis. — This is a disease in which the 
meninges, or covering of the brain, are inflamed. 

Symptoms.— The child may be fretful, the head and 
face become hot, red and painful, fever is high, carotids bound ; 
there are muscular twitchings, the eyes are open and staring, 
or the child may be drowsy and stupid. 

Sometimes a child may be at play, and without warning it 
suddenly clasps its head, screams and goes into convulsions, 
and often dies in a few hours, or it may rally for a few hours 



420 THEORY AND PRACTICE OF MEDICINE. 

and go into another convulsion, from which it may rally and 
merge into a high fever, and lay in a comatose condition. 

Prognosis. — Must be unfavorable and uncertain ; yet I 
have seen many cases rally and get well under homoeopathic 
treatment. 

Diagnosis. — This must be the same as given by Dr. 
Tanner, as recorded elsewhere under encephalitis or cerebritis. 

Treatment. — If the child is in convulsions it should be 
allowed to inhale a small quantity of the fumes of chloroform 
or ether until the spasms are broken. If the child remains in 
a stupor then the head should be showered with cold water 
from a height until it rallies. At first it may pay no atten- 
tion to the water, but usually after a few minutes it begins to 
move and feel. The operation should be continued until the 
child cries aloud. I usually place a tub to receive the water, 
the child is laid on its back so that the head projects over the 
tub. I then shield the child's eyes and mouth, and pour cold 
water out of a pitcher from a height, on the forehead, and con- 
tinue until the child is aroused. I have seen several cases re- 
stored in this way, by giving the indicated remedy as soon as 
it can swallow. 

Aconite. — High fever, hot dry skin, congestion of blood to 
the head. 

Apis. — Child lies in torpor; delirium, sudden shrieking 
cries, squinting, grinding teeth, boring head in pillow. 

Belladonna. — Violent throbbing in the head ; eyes red, 
sparkling, with furious look ; furious delirium, tries to escape ; 
great intolerance of noise and light ; starting and jumping 
during sleep, or sleepy, but can not sleep. 

Bryonia. — Violent pain with congestion of blood to the 
head ; delirious talking at night ; lips dry and parched, with 
great thirst ; worse when moving ; sitting up causes nausea 
and fainting. 

Cuprum acetate. — Fretful or apathy ; restless or disturbed 
sleep ; inability to hold the head erect ; convulsive move- 
ments and distortions of the limbs ; grinding of the teeth. 



THEORY AND PRACTICE OF MEDICINE. 42 1 

Gelsemium. — Is a valuable remedy for all brain troubles. 

Helleborus. — Usually in the last stage, when serous exu- 
dation has already taken place ; face pale and puffed ; sopor- 
ous sleep, with screaming and starting ; lower jaw sinking 
down ; chewing motions with the mouth ; automatic motions 
with one arm and one leg ; squinting, pupils dilated. 

Hyoscyamus. — Delirium with wild staring look, jerking 
of the limbs and throbbing of the carotids ; staring, distorted 
eyes, with double vision ; muttering, with picking at the bed- 
clothes. 

Opium. — Stertorous breathing ; eyes half closed ; delirious 
talking ; eyes wide open ; face purplish and swollen. 

Strammonium. — Delirium, with desire to escape ; disposed 
to talk continually ; grinding of the teeth, with shuddering ; 
glistening eyes and staring look. 

The patient may require some mental remedies after the 
disease is arrested. 

CEREBROSPINAL riENINQITIS. 

SPOTTED FEVER. 

This is a disease in which the meninges of the brain and 
spinal cord are involved. It is often endemic as well as epi- 
demic. After death the back, and sometimes the whole body 
turns spotted, hence it is called spotted fever. 

Symptoms. — The symptoms of this affection are simi- 
lar to those of cerebral meningitis and inflammation of the 
spine. 

In looking over my diary of thirty years ago, I find two 
typical cases of this disease, which I will transcribe. Annie 
M., eight years of age, was taken at three o'clock A. m., Wed- 
nesday, with shivering, skin cold, followed soon by vomiting 
and fever. I saw her at 10 A. M., the pulse was quick, weak 
and fluttering, eyes looked dull, pupils natural, skin of a lead- 
en hue, dry and hot, pain in the head, back painful and ten- 
der upon pressure over the vertebrae ; muscles of the neck and 



422 THEORY AND PRACTICE OF MEDICINE. 

back sore and contracted ; throat a little sore, agitation of the 
limbs ; tongue covered with a whitish fur, tip red, edges a little 
dark, bowels costive. At 3 P. M., I found the pulse growing 
weaker, the mind more confused, with partial delirium, head, 
neck and back hot ; twitching of the muscles. 

At 2 p. M., Thursday, I found her in a comatose condition, 
with spasms of the muscles of the neck and back, head drawn 
back, difficult breathing, and pulse almost imperceptible at the 
wrist. I let her inhale some fumes of ether until the muscles 
relaxed. Finding the pulse again imperceptible at the wrist, 
I dashed the head and shoulders with cold water, rubbed dry 
and rolled in a warm blanket ; the muscles relaxed and the 
pulse came up again, and she passed into a quiet sleep for 
fifteen minutes, after which I noticed the muscles of the face 
and neck begin to twitch, the body was tossed from side to 
side ; head and shoulders drawn back ; pulse again impercep- 
tible. I again dashed with the cold water, it had the same quiet- 
ing effect ; the pulse came up again for a few beats. At 3 
p. M., she appeared to be going into a hard spasm, when respi- 
ration was suddenly cut short and she expired, just thirty-six 
hours from the appearance af the first symptoms. 

Immediately after death the chest, back and thighs were 
covered with yellow spots, which soon turned purple as the 
body cooled. 

Martha T., aged twelve years, felt well in the morning, 
washed and went to comb her hair, found the muscles of the 
arms and shoulders sore, soon complained of stiffness of the 
limbs in trying to walk ; her jaws felt a little stiff, the pulse 
was quick and feeble ; her head began to draw backwards and 
the back became rigid. She lay in an opisthotonos condition , 
for three days before the muscles were sufficiently relaxed to 
permit her head to be turned without moving the whole body. 
This case recovered by homoeopathic remedies, belladonna 
and veratrum viride, prescribed at that time by an allopath. 

Pathology. — This is an asthenic grade of inflammation 
which causes infiltration of serum into the surrounding tis- 



THEORY AND PRACTICE OF MEDICINE. 423 

sues, and the capillaries are congested. Therefore, the capil- 
laries not being supplied with their accustomed stimulus, do 
not contract and expel their contents into the deeper channels, 
but retain the already disorganized materials, which rapidly 
undergo a zymotic change, producing : 1. Morbid action of 
the nerves which supply and control the circulation. 2. 
Those of the respiratory system, producing death in a few 
hours, or if the patient survives the first shock to the nervous 
system, he at last succumbs to the symptoms of pyaemia, un- 
less relieved in the first stage. 

Prognosis. — This has formerly been considered a very 
fatal disease, but homoeopathic treatment has greatly lessened 
its mortality. 

Diagnosis. — Pain in head, and pain and tenderness of 
the spine, with opisthotonos tendencies, distinguish this dis- 
ease from all others. 

Causes.— Not well understood. A certain epidemic in- 
fluence, and localities seem to favor its development. 

Treatment. — As I repeat the following remedies it will 
be readily seen they are homoeopathic to cerebro-spinal fever. 

Aconite. — Chill, fever, restlessness, and great thirst ; crawl- 
ing or numbness in the spine. 

Arnica. — Soreness in all the limbs as if bruised; ecchy- 
mosed spots on the skin. 

Belladonna. — Violent throbbing headache ; great soreness 
and stiffness of the neck ; dilated pupils, with double vision ; 
delirium with frightful figures before the eyes. 

Bryonia. — Splitting headache, worse from motion ; stiff- 
ness of the neck. 

Cimicifii^a racemosa. — Intense pain in the head, as though 
a bolt were driven from the neck to the vertex with every 
throb of the heart ; stiffness of the back ; tonic and clonic 
spasms ; intense pain in the eye-balls ; tongue swollen. 

Crotalus. — Horrid headache, with feeling of tightness in 
the brain ; red face and delirium, with open eyes ; red spots 
on all parts of the body ; pain in the limbs. 



424 THEORY AND PRACTICE OF MEDICINE. 

Gelsemium. — Dull pain in back part of the head ; feels as 
if intoxicated ; paralysis of the eye-lids ; double vision and 
dilated pupils ; complete loss of muscular power ; pulse very 
feeble ; labored breathing, nausea and vomiting. 

Opium. — Stupor and deep, slow breathing ; very quick or 
very slow pulse ; drawing the body backwards and rolling it 
from side to side ; spasms, with tossing of the limbs. 

Veratnim viride. — Meningitis, high fever, intense conges- 
tion ; vomiting ; or face haggard, cold and pulse slow ; con- 
vulsions with opisthotonos. 

Spinal Meningitis. — The symptoms are so similar to 
those of cerebro-spinal fever, with the exception of the head 
symptoms, and the treatment being similar I need not repeat 
them here but refer the reader to that disease. 



SPINAL IRRITATION. 

Symptoms. — This is simply a congestion of the spinal 
cord, but not active enough to produce inflammation, but 
simple irritation. It often produces obscure symptoms in 
distant organs and tissues. Unless the spine is examined we 
may be mistaken as to the real trouble. Some forms of 
functional derangement of the heart, pains of the chest, stom- 
ach, bowels, ovaries and uterus, are due to irritation of their 
nerve supply, as the nerves pass out from the spine. 

Diagnosis. — Pressure on the nerves near the vertebrae, 
as they leave the spinal column, causes tenderness and pain. 
As a rule, if pressure directly on the spinous processes causes 
much pain or tenderness without fever, then we may suspect 
hypersesthesia, or chronic inflammation of the meninges of 
the cord. 

Treatment. — Aconite, agaricus, belladonna, cimicifuga, 
gelsemium, ignatia, nux vomica, rhus tox., and veratrum 
viride, are all indicated remedies at some stage of spinal irri- 
tation. 



THEORY AND PRACTICE OF MEDICINE. 425 

CONCUSSION OF THE SPINE. 

This is produced by falls or blows on the spine. 

Symptoms. — A numb or tingling sensation in the back 
and lower limbs. 

Treatment. — This calls for arnica, cicuta, dioscorea, 
and hypericum. If the concussion is produced by a stretch- 
ing or strain of the spine, rhns tox. will be indicated. 

COCCYXITIS. 

INFLAMMATION OF THE COCCYX. 

This is an irritation or inflammation of the coccyx or last 
bone of the spinal column. It may be caused by falls, and 
when neglected often leads to serious trouble, and renders pa- 
tients bed-ridden for life. 

Treatment. — Whenever a person receives a fall or blow 
on the sacrum a solution of arnica should be applied, and 
arnica given internally. Carbo animalis, cicuta virosa, cistis 
canadensis are valuable agents. 

CEREBRAL AND SPINAL SCLEROSIS. 

This signifies a hardening of the brain and spinal cord, 
probably due first to inflammation. There is also a condition 
following inflammation either acute or chronic, called soften- 
ing of the brain. These subjects are obscure and we can only 
judge of their presence by some forms of insanity, and certain 
conditions of the eyes. I need not go into the symptomology 
here, but refer the reader to cerebral and spinal meningitis. 
The treatment must be similar. 

ANGULAR CURVATURE OF THE SPINE. 

This is a deformity of the spine due to caries of the ver- 
tebrae. It is known as kyphosis, lordosis, and Pott's curvature. 
I have already given the treatment under caries of the spine, 
to which the reader is referred. 



426 THEORY AND PRACTICE OF MEDICINE. 

SK0L10S1S. 

LATERAL CURVATURE OF THE SPINE. 

This means a bending of the spine either to the right or 
left, and sometimes both, giving the spine the appearance of the 
letter S. It is due to general weakness of the spine in delicate 
girls, and to certain occupations causing them to lean to one 
side. 

Treatment. — The patient must be trained to lie on the 
back in a straight position. The diet and general sanitary 
surroundings must be changed. A brace to hold the patient 
erect should be worn, if relief is not obtained by medicine. 
Sponge-bath to the spine once a day with sea-salt and water 
is highly beneficial. Arnica, calcarea card., calcarea phos., 
nux vomica, phosphoric acid, Pulsatilla, rhus tox., silicea and 
sulphur, are all recommended. 



THEORY AND PRACTICE OF MEDICINE. 427 



DISORDERS OF THE MIND. 

The following diagram will illustrate the various forms of 
insanity. 

General f Mania, 

1 Dementia. 



Insanity. <| 



f Moral Insanity, 
Partial < Monomania, 

^Insane Impulse. 
L Mania a Potu, Delirium Tremens, 



Wood says : By general insanity is meant a derangement, 
in a greater or less degree, of all the cerebral functions con- 
nected with mind ; by partial insanity, a derangement of one 
or a portion only of these functions. Mania is that form of 
general insanity in which there is an exaltation of the cere- 
bral actions ; dementia, that in which the brain is enfeebled, 
and the mental operations all participate in its weakness. 
Partial insanity takes the name of moral insanity, when it 
effects only the emotional functions, as contra-distinguished 
from the intellectual ; of monomania, when, with a general 
soundness of thought, there is delusion upon some one point, 
or in some one direction ; and of insane impulse, when, with- 
out reflection, and without any known perversion of feelings 
or passions, the patient is irresistibly impelled to some insane 
act. 

Taylor gives the following definitions of insanity from a 
legal standpoint. 1. Dementia naturalis corresponding to 
idiocy ; and 2. Dementia adventitia, or accidentalis, signifying 
general insanity as it occurs in persons who have once enjoyed 
reasoning power. To this state the term lunacy is also ap- 
plied, from an influence formerly supposed to be exercised by 



428 THEORY AND PRACTICE OF MEDICINE. 

the moon on mind. Lunacy is a term generally applied by 
lawyers to all those disordered states of mind which are known 
to medical men under the names of mania, monomania and 
dementia ; and which are generally, though not necessarily, 
accompanied by lucid intervals. The main character of in- 
sanity, in a legal view, is said to be the existence of delusion ; 
i. e., that a person should believe something to exist which 
does not exist, and that he should act upon this belief. 

Unsoundness of Mind. — Besides the terms idiocy and 
lunacy, we find another frequently employed in legal proceed- 
ings ; namely, unsound — (non compos mentis) — of the exact 
meaning of which it is impossible to give a consistent defini- 
tion. 

riANIA. 

In this form of insanity, there is a general derangement 
of the mental faculties, accompanied by greater or less ex- 
citement, sometimes amounting to violent fury. The indi- 
vidual is subject to hallucinations and illusions, the dif- 
ference in the meaning of which terms it may here be proper 
to explain. Hallucinations are those sensations which are 
supposed by the patient to be produced by external impres- 
sions, although no material objects may act upon the senses at 
the time. Illusions are sensations produced by a false percep- 
tion of objects. When a man fancies he hears voices, while 
there is profound silence, he labors under a hallucination ; 
when another imagines that his ordinary food has an earthy or 
metallic taste, this is an illusion. Illusions sometimes arise 
from internal sensations, and give rise to the most singular 
ideas. When a hallucination or an illusion is believed to have 
a real and positive existence, and this belief is not removed 
either by reflection or an appeal to the other senses, the indi- 
vidual is said to labor under a delusion ; but when the false 
sensation is immediately detected, and is not acted on as if it 
were real, then the person is sane. Perhaps this is the most 



THEORY AND PRACTICE OF MEDICINE. 429 

striking distinction which it is in our power to draw between 
sanity and insanity. Illusions refer to the senses — delusions 
to the judgment. 

Symptoms. — This disease sometimes comes on sud- 
denly, but more frequently slowly and almost imperceptibly, 
being preceded by a period of incubation of variable length, 
extending from some days or weeks to as many months or 
years. The symptoms of this period of incubation are an al- 
ternation in the thoughts, habits, taste, temper and affections, 
the patient becoming more and more the reverse of his 
former self. The general health suffers at the same time; 
the appetite fails ; the sleep is disturbed ; the bowels are 
confined or irregular, or affected with diarrhea ; the tongue 
is furred ; the pulse frequent and quick ; the patient grows 
thin, and features alter. 

The following symptoms are usually present: Anxiety, 
uneasiness, restlessness, sleeplessness, alternate excitement and 
depression, or continued agitation and violent muscular efforts ; 
rapid, incoherent discourse, fits of loud laughter, or loud 
shoutings, grinding of the teeth, spectral illusions, mental de- 
lusions, unfounded antipathy to certain persons, particularly 
to near relatives and dear friends. There is a peculiar wild- 
ness and fierceness of the countenance ; the pupil is dilated ; 
the eye-lids widely open, the eyes glistening and unsteady ; 
the features strongly marked ; the countenance flushed. 

Many maniacs have lucid intervals, which recur with reg- 
ularity. They are also capable, under certain circumstances, 
of considerable self-restraint and of concealing their delusions 
or designs, and they will carry out their plans with the cun- 
ning of rogues, and the contrivance of sane men. It matters 
not how quiet an insane person is, they must be watched 
every moment, for at a time when least expected, the patient 
may commit suicide or murder. 

Causes. — Hereditary predisposition ; violent and stim- 
ulating emotions of the mind ; uncurbed and immoderate in- 
dulgence of the passions ; violent exercise ; frequent intoxi- 



430 THEORY AND PRACTICE OF MEDICINE. 

cation ; excessive study ; suppression of periodical and other 
evacuations ; long-continued discharges ; parturition or lacta- 
tion ; certain diseases of the brain ; preceding attacks of epi- 
lepsy, fever, etc. 

Diagnosis. — From inflammation of the brain and its 
meninges ; by mania, having no fever ; delirium tremens has 
a trembling nervous feeling, which is not usual in mania. 

Prognosis. — Favorable when the forerunner of cur- 
able diseases or a single indulgence in spirituous liquors ; the 
attacks being slight. 

Unfavorable. — Coming on after the middle period of 
life, or of long continuance. 

Treatment. — Agaricus. — Heaviness and languor of the 
lower extremities ; merry, excited mood. 

Anacardium. — Rapid loss of self-reliance, memory and 
mental vigor. 

Arsenicum. — Intermittent symptoms or periodic exacer- 
bations. 

Belladonna. — Sleeplessness, delirium, mania ; intolerance 
of noise and light ; headache, flushed face ; sparkling, brilliant 
eyes ; dilated pupils ; tottering gait ; hallucinations both vis- 
ual and auditory ; phosphatic urine ; generally requisite in 
hypersemia of the brain. 

Hyoscyamus. — Delirium, with hallucinations, but with 
little determination of blood to the brain ; twitchings, start- 
ings and mutterings ; dryness of mouth ; dilatation of pupils 
and giddiness ; melancholy ; silent humor. 

Iodine. — Anxiety and despondency, discouragement and 
dispiritedness, obstruction of vision, illusion of the sense of 
touch, partial deafness ; for scrofulous patients. 

Mercurius. — Nervous irritability, slight causes producing 
great impressions ; fretful, peevish, irritable temper ; sleepless- 
ness ; loss of memory ; delirium ; apathy. 

Nux vomica. — Giddiness and reeling as if drunken; in- 
tolerance of light and sound, rushing noises in the ears ; con- 
stipation, irrascibility ; drowsy in evening, and awake early in 



THEORY AND PRACTICE OF MEDICINE. 43 1 

the morning ; particularly suited to active business men, who 
have mental occupation and little open-air exercise, and who 
are addicted to wine, coffee, and tobacco. 

Phosphoric acid. — Depression of spirits, and disorder of the 
mental faculties, particularly when due to brain-fag. 

Strammonium. — Furious delirium, with hallucinations ; 
excessive talking, singing, striking, biting, shrieking; the 
pupils are dilated, the eyes glisten, and the whole aspect is 
furious ; or there may be a besotted expression with convul- 
sions, paralysis, and difficult deglutition. 

Veratrum album. — Anguish of mind; vertigo with obscu- 
ration of sight ; collapse of pulse. 

Veratrum viriole. — Insanity from cerebral congestion ; puer- 
peral mania ; silent, suspicious ; will not see her physician, he 
seems to terrify her ; fears being poisoned ; sleepless, can hardly 
be kept in her bed-room. 

Zincum. — Repeats all questions before answering them ; 
stares as if frightened on waking, and rolls from side to side. 

Aurum metallicum. — Suicidal tendency, religious mania ; 
determination of blood to the brain, great depression, with con- 
gestion of the head and liver. 

An insane person, if not sent to an insane asylum, should 
be removed to some locality where he cannot see the associa- 
tions by which he was surrounded when afflicted. In the early 
stage when the patient is manageable he should be taken on 
a pleasant journey far removed from the scenes, climate or the 
exciting causes of his affliction. He should be pleasantly 
amused ; music sometimes has a pleasing effect upon the 
patient. Cold salt-water sponge, or shower bath, is often grate- 
ful to the patient, and is often highly beneficial. He should 
have good nourishing diet, fresh air, and be clothed warm and 
comfortable. 



432 THEORY AND PRACTICE OF MEDICINE. 

DEMENTIA. 

IDIOCY — IMBECILITY. 

Dementia. — In this state there is a total absence of all rea- 
soning power. The mental faculties are not perverted but 
destroyed. There is a want of memory as well as a want of 
consciousness, on the part of the individual, of what he does 
or says. It is by no means an unfrequent consequence of 
mania or monomania — but it has been known to occur sud- 
denly in individuals, as an effect of a strong moral shock. 

Idiocy, Imbecility. — Idiocy is characterized by want of 
mental power, being congenital ; while mania, monomania, and 
dementia, (from the dementia accidentalis) idiocy, forms the 
dementia naturalis of lawyers. This intellectual deficiency is 
marked by a peculiar physiognomy, an absence of all expres- 
sion, and a vague and unmeaning look, whereby an idiot may 
in general be clearly identified. In many cases of congenital 
deficiency, the mind is capable of receiving a few ideas, and 
of profiting to a certain extent by instruction. To this state 
the term imbecility is applied. It may be regarded as a minor 
degree of idiocy. The mind of an imbecile can never be 
brought to a healthy standard of intellect, like that of an ordi- 
nary person of the same age. The degree to which congeni- 
tal deficiency of intellect exists, is generally well marked by 
the power of speech, or of communicating ideas by language. 
In idiocy there is no speech, or only an utterance of single 
words ; in the better class of imbeciles, the speech is but little 
effected ; while there is every grade between these two. 

Causes. — Sunstroke, fever, brain-fag, melancholia, mania, 
old age. Opium and alcoholic liquors in early life may pro- 
duce that form of dementia called imbecility. 

Treatment. — Imbecility may be benefited by treat- 
ment, but there is no hope for idiocy. 

Anacardium, helleborus, nux vomica, phosphoric acid and 
zinc, may be used with the hope of benefiting your patient. 

The demented should be carefully nursed and kindly and 
tenderly treated. 



THEORY AND PRACTICE OF MEDICINE. 433 

MORAL INSANITY. 

Writers are not agreed on the subject of moral insanity. 
Dr. Prichard denned it to be : " A morbid perversion of the feel- 
ings, affections, and active powers, without any illusion or er- 
roneous conviction impressed upon the understanding." Dr. 
Wood says: "There are numerous individuals mingling in 
society, and participating in the ordinary avocations of other 
men, whose sentiments and conduct are so peculiar as to at- 
tract general attention, but who can reason so well upon all 
subjects within their capacity, and whose intellect is often so 
clear, and, in many instances, even strong, that no one ques- 
tions their sanity. They are simply said to be singular or 
eccentric. Now the fact is, that such individuals are not un- 
frequently as much under the control of their morbid feelings, 
act as irrationally in obedience to these feelings, and are mor- 
ally as little responsible for their acts, as others who carry 
out in their conduct some false conclusion of the intellect. 
Such persons should certainly be considered as insane. 

Medically speaking, says Dr. Alfred Swaine Taylor, there 
are, according to Dr. Prichard, two forms of insanity, moral 
and intellectual ; but in law there is only one. 

MONOMANIA. 

AFFECTIONS OF THE SENTIMENTS. 

Under this head Alden's Encyclopedia recognizes the fol- 
lowing : Melancholia, exaltation of grief, penitence, and anx- 
iety ; monomania of fear, exaltation of consciousness ; mono- 
mania of pride, exaltation of self-esteem ; monomania of super- 
stition ; exaltation of the sense of law, devotion, and the mar- 
velous ; monomania of suspicion, exaltation of jealousy, envy, 
want of confidence ; monomania of vanity, exaltation of crav- 
ing for applause, grandeur, of feeling of ambition. 

In speaking of monomania, Dr. A. S. Taylor says : This 
name is applied to that form of insanity in which the mental 

28 



434 THEORY AND PRACTICE OF MEDICINE. 

alienation is partial. The delusion is said to be confined 
either to one subject or to one class of subjects. One fact is 
well ascertained, that monomania varies much in degree ; for 
many persons affected with it are able to direct their minds 
with reason and propriety to the performance of their social 
duties, so long as these do not involve any of the subjects of 
their delusions. Further, they have occasionally an extraor- 
dinary power of controlling their thoughts and emotions, as 
well as of concealing the delusions under which they labor. 
This implies a consciousness of their condition not met with 
in mania ; and it also appears to imply such a power of self- 
control over their thoughts and actions, as to render them 
equally responsible with a sane person for many of their acts. 
In a real case of monomania, it is not to be supposed that a 
man is insane upon one point only, and sane upon all other 
matters. The only admissible view of this disorder is that 
which was taken by Lord Lyndhurst, in one of his judgments. 
In monomania, the mind is unsound ; not unsound in one 
point only, and sound in all other respects, but this unsound- 
ness manifests itself principally with reference to some particu- 
lar object or person. 

INSANE IMPULSE. 

IMPULSIVE MADNESS. 

Wood in speaking of this affection says : The existence of 
this form of insanity unconnected with moral insanity or mono- 
mania, has been doubted ; but cases every now and then occur, 
which can be explained in no other way. Persons in the per- 
fect possession of their intellect, with no predominant passion, 
are seized with an unaccountable propensity to do some insane 
act, without motive or object appreciable by themselves or 
others. Sometimes they rush headlong to the act in obedience 
to the impulse, which takes them as it were by surprise, so 
that they have apparently no time for resistance. In other in- 
stances, the impulse less immediate and powerful, and the pa- 



THEORY AND PRACTICE OF MEDICINE. 435 

tient is able to resist it for a time, or even to conquer it alto- 
gether, or at any rate to hold out against it, until the morbid 
condition of brain in which it originates ceases spontaneously, 
or under the influence of remedies. 

During the continuance of such an affection, says Alden, 
three mental conditions are distinctly traced. 1. The sud- 
den arising and irresistible dominion of a propensity ; 2. The 
abolition or impairment of the apprehension of the real and 
ordinary relations of the individual ; 3. The suspension of 
the powers by which such propulsions are prevented from 
arising, or ruled and regulated when they do arise. 

A lady is mentioned who never entered church, but she 
was impelled to shriek, or saw plate-glass, but she was im- 
pelled to break it ; and the incongruous laughter, the gro- 
tesque gesticulations, and the involuntary and repulsive asso- 
ciations, to which good and great men have been subject, all 
must be placed under this category. The treatment of all 
the various forms of insanity must be the same as that for 
mania. 

The minor forms of mental weakness are classified as follows 
by Alden. 

Affections of Propensities. — Dipsomania, uncontroll- 
able craving for stimulants. Homicidal-mania, impulsive 
desire to destroy life. Kleptomania, uncontrollable desire to 
acquire. 

MANIA A POTU. 

delirium tremens. 

Symptoms. — Sleeplessness; restlessness; delirium, 
during which the patient recognizes those about him, answers 
questions rationally, and does hurriedly what he is told to do ; 
trembling of lips, hands and muscles, is generally present, 
and more particularly in speaking, or on making any effort 
to be doing something ; he fancies that he is surrounded with 
enemies, or that he is in a strange place from which he is 



436 THEORY AND PRACTICE OF MEDICINE. 

constantly endeavoring to escape ; or he thinks that some 
great evil is impending, or has actually befallen him. He is 
suspicious of those about him, and is tormented with fright- 
ful images or sounds, and will often be found busily looking, 
in unlikely places, after some object or other, on which his 
mind is intent. He is rarely violent, at least in the best 
marked cases of the disease, but he sometimes exposes him- 
self to danger in endeavoring to effect his escape, There is 
profuse perspiration, a moist and slightly furred tongue, and 
a frequent pulse. In fatal cases the delirium is often re- 
placed by coma ; the tremor passes into subsultus tendinum, 
and the evacuations become involuntary. In other cases 
the coma is rapidly followed by embarrassed respiration, the 
mucous rale, and death by apncea. 

Patients are often annoyed with the belief that there are 
snakes in their boots, and they imagine that they see serpents 
crawling around the walls, and on their beds. The wild and 
terrified look shows that they are tortured beyond description. 

Treat the poor drunkard kindly, he is to be pitied; his 
appetite for liquor has become a disease, and in many cases 
he is utterly incapable of refraining from its use. I well 
remember a fine gentleman, and splendid book-keeper, who 
had not tasted a drop in eight months. He shunned the sa- 
loons where he had been in the habit of indulging. One day 
he was in a deep study, and going home he did not realize 
that he was passing his old drinking-place until some one 
opened the door just as he was passing ; he got a whiff of the 
saloon, and he told me that it was utterly impossible for him 
to resist the temptation to go in and take a drink. Poor fel- 
low, he continued to drink and slipped away from home, and 
hid in an old barn, where he drank until he killed himself. 
When found he was unable to help himself ; he was carried 
to his home and laid on the portico until my arrival. When 
I took hold of his pulse he opened his eyes, and said : " Doctor, 
it is my last," and the poor fellow expired in two minutes. 
My heart ached for him ; he was a man of fine address and 



THEORY AND PRACTICE OF MEDICINE. 437 

kind-hearted. I tell you this, that you may not upbraid poor 
drunkards, for after they have passed a certain point the appe- 
tite is irresistible. 

Diagnosis. — Meningitis has headache and fever ; deli- 
rium tremens has none, and has trembling of the hands. 
There is sometimes delirium, and trembling of the limbs, 
which is caused by a poisoned condition of the brain by a con- 
gested liver, in which case, the bile, instead of passing off by 
the gall-duct, is retained in the circulation, and hence the 
brain becomes so affected as to produce a condition resembling 
delirium tremens ; so you must be on your guard and not make 
a mistake, for if you make an incorrect diagnosis, you may 
lose a good family thereby, as some men are very sensitive on 
that subject. 

Prognosis. — Is favorable or unfavorable in accordance 
with the number of the attacks, and the condition of the 
patient's general health. If a person takes an over-dose of 
alcoholic spirits, who has not been used to it, then the prog- 
nosis is favorable. 

Pathology. — There is an effusion of serum in the ven- 
tricles, at the base of the brain, under the archnoid, or in all 
these situations ; injected state of the pia mater. Alcohol has 
been detected in the serum of the ventricles. If the patient is 
a habitual drinker, then the white and gray matter are har- 
dened, and when the hardening process reaches a certain point 
death must follow. 

Treatment. — As the patient is in great danger of im- 
mediate prostration, he must be nourished and stimulated with 
strong coffee and beef essence, both of which are organic stim- 
ulants. Malted milk is a valuable nutritious substance. 

I think it best to withdraw alcoholic stimulants, and if 
arterial stimulants are necessary, then cayenne pepper tea may 
be given ; or carbonate of ammonia given in sweetened water 
often acts like an antidote. 

I have referred to this matter because it is a disputed ques- 
tion whether the patient should be allowed alcoholic stimu* 



438 THEORY AND PRACTICE OF MEDICINE. 

lants in moderation or not ; or, in other words, let him taper 
off gradually. It seems to me that there is no sound philoso- 
phy in continuing the alcohol after the patient has been pois- 
oned with it. There is as much reason in such a procedure 
as to try to put out a fire while you are adding oil to the flame 
once in a while. 

If a patient is so far prostrated that he requires immediate 
nourishment and stimulation, then the beef essence, strong 
coffee, cayenne pepper, and carbonate of ammonia, are your 
best organic and arterial stimulants in case of emergency. 

The patient must be kept in a quiet, darkened room, and 
procure sleep as soon as possible, for without sleep the patient 
must die and that speedily. 

The following is from an allopathic author : It has been 
found, from a large amount of experience in various parts of 
the United States, that the strictly opiate plan is not so suc- 
cessful as a mildly stimulating course. The extreme wake- 
fulness is a strong temptation to administer morphia, or simi- 
lar preparations. If these, however, do not produce a soporific 
effect immediately, they greatly aggravate the malady, and 
convert a moderate hallucination into a most violent raving. 
Thus you see that the old school are not fully agreed as to the 
proper treatment for delirium tremens. 

As usual, in all other cases, homoeopathy furnishes a ra- 
tional plan of treatment. 

Antimoninm tart. — Nausea and vomiting with headache 
and trembling of the hands. 

Belladonna. — Imagines he sees ghosts, hideous faces and 
various insects ; delirium ; is afraid of imaginary things ; sees 
monsters ; desires to escape or hide ; trembling in all the 
limbs ; weakness, and tottering gait ; sleepy, yet can not sleep ; 
starts as in affright. 

Belladonna is a grand remedy to quiet nervous excitability 
and procure rest in delirium tremens. 

Capsicum. — Lack of reactive force; vital forces sunken ; 
weak, exhausted. 



THEORY AND PRACTICE OF MEDICINE. 439 

Hyoscyamus. — Sees persons who are not and Have not been 
present ; delirium tremens, with clonic spasms ; averse to light 
and company ; visions, as if persecuted. 

Nux vomica, — This is the first remedy to begin the treat- 
ment of delirium tremens ; with over-sensitiveness, nervous ex- 
citability and malicious vehemence ; sudden failing of strength ; 
trembling all over ; mostly of the hands ; in drunkards. 

Opium. — Drunkenness, with stupor, eyes burning and dry ; 
delirious talking, eyes wide open, face red, puffed up ; mania 
a potu, with dullness of the senses, and at intervals, sopor, with 
snoring ; sees animals ; affrighted expression of face ; inbe- 
cility of will. 

Strammonium. — Hallucinations, which terrify the patient ; 
sees ghosts, hears voices back of his ears ; sees strangers or 
imagines animals are jumping sideways out of ground, or run- 
ning at him. 

When you see a patient with delirium tremens, that seems 
almost utterly prostrated, and his nerves so unstrung that 
without rest he must die, then you may give him fifteen to 
twenty drops of chloroform in a little mucilage syrup and 
water. It acts as a stimulant when taken internally, and also 
quiets nervous excitability and procures sleep, and when he 
awakes and feels refreshed, then you will have a better oppor- 
tunity to select the appropriate remedy. 



COUP DE SOLEIL. 

SUN-STROKE. 

This is also called thermic fever, heat-apoplexy, heat- 
asphyxia, erythismus tropicus and insolatio. The symptoms 
are greatly modified in different cases. In some there is a 
tendency to fainting (heat syncope) ; in others the symptoms 
are apoplectic (heat apoplexy) ; in still others the characteris- 
tic feature is the excessive development of heat (hyperpyrexia) 
to 110 F., or higher. 



440 THEORY AND PRACTICE OF MEDICINE. 

Symptoms.- — Often the first indication that the patient 
has is, he finds his skin getting hot and dry ; the head be- 
comes extremely hot, with vertigo ; face red and hot, eyes red 
and swollen ; the face becomes bloated, and the patient be- 
comes comatose, unconscious, and has stertorous breathing. 
Sometimes the disease is preceded by thirst, but often the pa- 
tient is suddenly prostrated on the streets, and dies before 
medical aid can reach him. 

This disease is very common in India, and other tropical 
countries, and during hot summer months in the United 
States, and other temperate lands. Sun-stroke never occurs 
on board of vessels on the ocean. It has never been known 
in Florida ; that is due to the constant sea-breeze. 

Causes. — The predisposing causes are : i. Unusually 
high temperature, with great dryness in the air ; 2. The elec- 
tric condition of the atmosphere that precedes a thunder- 
storm ; 3. A contaminated atmosphere from overcrowding ; 
4. All debilitating causes, such as prolonged marches, pre- 
vious disease, intemperate habits, etc. 

Diagnosis. — The history of the case, by exposure to 
the rays of the sun, or heat of crowded rooms, and the intense 
heat of head, distinguish this disease from all others. 

Prognosis. — More than half die under the old treat- 
ment. Not so fatal in the hands of homoeopaths. 

Treatment. — The first thing to be done in sun-stroke 
is to shower the head with cold water. If the patient can not 
swallow, then you should hold spirits of camphor to his nose, 
which acts as a stimulant and causes the patient to rally. 
After the patient rallies a little, or if the pulse is full and 
rapid, then you continue the application of cold water to the 
head and shoulders, and give one of the following remedies as 
they seem to be indicated. 

Aconite. — When the head is hot, pulse quick and bound- 
ing. It may be continued until fever abates, and then if other 
agents are required you must select them from the symptoms 
present. 



THEORY AND PRACTICE OF MEDICINE. 44 1 

Belladonna. — Face and eyes red and glistening, vertigo ; 
patient often falls down suddenly ; sensitive to light. 

Bryonia. — Worse on moving, nausea, and vomiting when 
raising up. 

Camphor. — Great depression of the pulse, and pale face, 
with violent distress in the head ; followed immediately by a 
reaction — face flushed, accelerated pulse, etc. 

Glonoine. — This is a grand remedy for sun-stroke ; very 
severe, heavy and throbbing pain in the head, particularly at 
the back ; or, sudden loss of consciousness ; if a patient has 
warning in time glonoine will often arrest the disease ; it 
should always be given when a patient complains of head, 
from heat. 

Gelsemium. — Vertigo, confusion of the head, spreading 
from occiput over whole head ; pupils dilated, dim sight ; 
general depression from heat, sun or summer ; severe pain in 
forehead and vertex, dim sight, roaring in the ears ; head feels 
enlarged. 

Helleborus. — Drowsiness and headache, continuing after 
the heat of the body is reduced. 

Hyoscyamiis. — Persistent convulsions and startings. 

Advise all persons who are exposed to artificial or sun heat, 
to carry a damp sponge in their hats, and as soon as they find 
their heads getting hot to apply cold water at once from a 
pump on the streets. When convenient it is best to shower 
the head with ice-water. 



443 



THEORY AND PRACTICE OF MEDICINE. 



CUTANEOUS SYSTEM. 



The following table will show the various skin diseases 
and their nomenclature not included under the list of idio- 
pathic eruptive fevers. 



Skin Diseases. < 



Exanthema. .Rashes. 
Vesiculae. . . .Vesicles. 

Bullae Blebs. 

Pustulae . . . .Pustules. 

Papulae Pimples. 

Squamae . . . .Scales. 
Tuberculae . . Tubercles. 
Maculae .... Spots. 



Under the head of exanthema or rashes we have the fol- 



lowing list. 



Rashes. 



Erythema . 
Urticaria . 
Roseola . . 
Intertrigo . 



Inflammatory Blush. 
Nettle-rash. 
Rose-rash. 
. Chafing of Infants. 



ERYTHEMA. 

INFLAMMATORY BLUSH. 

This disease is characterized by redness of the skin. 
There are six species, viz. : Erythema fugax, fleeting redness ; 
erythema laeve, redness upon an edematous swelling ; erythe- 
ma papulatum, red spots the size of a pin's head to that of a 
small split-pea ; erythema tuberculatum, redness with hard 
knobs; erythema centrifugum, or marginatum, redness with 
well denned circumference ; erythema nodosum, large red 
spots. There is little or no swelling, pain or fever, thus mak- 
ing the diagnosis easy between erysipelas, rubeola and scarlet 
fever. 



THEORY AND PRACTICE OF MEDICINE. 443 

Causes. — Anything that disturbs digestion, or irritates 
the skin. 

Treatment. — Apis for erythema laeva and nodosum ; 
belladonna for simple redness ; kali bichromicum may be 
called for in erythema papulatum ; nux vomica is valuable 
for redness of the skin after eating. Indigestion must be cor- 
rected and any other supposed cause of the disease. 



URTICARIA. 

NETTLE-R ASH. 

There are several varieties of this disease named by authors, 
but for all practical purposes, I only mention urticaria evanida, 
evanescent, without fever ; urticaria febrilis, with fever. 

Symptoms. — Sometimes, without warning, the patient 
is covered with an eruption, resembling that produced by the 
stinging of nettles, whence its name. The welts often swell 
and look like musquito bites, itch and burn. The spots do 
not contain any fluid, and never desquamate. 

Causes. — Indigestion, bitter almonds, cucumbers, mush- 
rooms, and shell fish. 

Treatment. — Aconite for the febrile variety. Apis has 
a stinging sensation with a swollen condition of the rash. 

Dulcamara, — Much itching ; after scratching it burns ; 
increases in warmth, better in cold. 

Nux vomica. — Urticaria, with gastric derangement. 

Pulsatilla. — Urticaria, with diarrhea, itching worse at 
night; ; from pastry or pork ; from delayed menses. 

Rhus tox. — Urticaria from getting wet, worse in cold air. 

Urtica urens. — Itching and burning, skin raised, red, 
blotches, requires constant rubbing. 

The diet and digestion must be corrected by the means 
recommended for dyspepsia. 



444 THEORY AND PRACTICE OF MEDICINE. 

ROSEOLA. 

ROSE-RASH. 

From the resemblance of the rash in this disease to that 
of measles it has been called false measles. There is, however, 
no catarrhal symptoms in roseola as there is in measles. The 
rash is coarser than that of scarlet fever, and the sore-throat 
and strawberry tongue are absent. The rash is sometimes so 
abundant that many mistakes have been made in diagnosis. 
It requires little or no treatment, the patient must be kept 
moderately warm, and if any symptoms arise, aconite, bella- 
donna or rhus tox., will be all that will be needed. 

INTERTRIGO. 

CHAFING OF INFANTS. 

This disease is characterized by redness and soreness of 
the skin caused by friction. There may be internal causes 
or it may be simply an irritation of the cuticle. The folds 
of the neck, axilla, groin and hips are the parts affected. 

Treatment. — I have never seen any case that did not 
yield readily to belladonna 3X internally and a lotion com- 
posed of fifteen drops of tincture of belladonna to a pint of 
water. Saturate cloths in the lotion and apply to the in- 
flamed parts, and repeat as often as the cloths become dry. 
Calendula lotion of the same strength, and applied in the 
same way, gives splendid results. Where the parts are tender 
and chafing has a tendency to return, I have found great and 
permanent relief from powdering the parts with the com- 
pound sterate of zinc. 

Scrofulous children may require calcarea carb. Cham- 
omilla, lycopodium, mercurius and sulphur, may be required in 
some constitutions. 

f Varicella . . . .Chicken-pox. 
v J Eczema Humid Tetter. 

I Herpes Tetter — Shingles. 

L Scabies Itch. 



THEORY AND PRACTICE OF MEDICINE. 445 

VARICELLA. 

CHICKEN-POX. 

Authors place this disease under the classification of idio- 
pathic eruptive fevers ; but as it is rarely accompanied with 
much fever, I have placed it in the classification of vesicular 
diseases. 

The disease is often so mild that the first evidence of its 
presence is made known by the appearance of one or more 
vesicles on the back. Usually, however, the child looks lan- 
guid, with loss of appetite for several meals, and reddish 
pimples appear on the back. About the second day the 
pimples become vesicles containing a colorless fluid. About 
the third or fourth day the vesicles dry and form scabs. The 
disease runs its course in from five to seven days, when the 
scabs are all off and leave no scars. 

Diagnosis. — Variola is the only disease that is liable to 
baffle us. But when we remember that the eruption of va- 
riola appears on the forehead about the third day, while the 
eruption in varicella appears within twenty-four hours and on 
the back first, the scabs fall off about the fifth day, at which 
time the eruption in variola is just completed. 

Treatment. — Rhus tox. is often the only remedy re- 
quired, but if the child is feverish then a few doses of aconite 
may be required. If there is tenderness of the throat, head- 
ache, red face, belladonna will be indicated. 

If there is excessive itching or stinging sensation in the 
base of the vesicles, then apis is the indicated remedy. 

The child should be kept within doors to avoid cold, and 
a light diet should be enjoined. As the disease is contagious 
cases should be isolated. 

ECZEMA. 

HUMID TETTER. 

This disease is characterized by redness of the skin, with 
closely packed vesicles about the size of a pin's head, which 



446 THEORY AND PRACTICE OF MEDICINE. 

coalesce, burst and pour out a serous fluid, which dries into 
thin yellow crusts. The rash is attended with itching, smart- 
ing and pain. The disease is known as catarrhal inflamniation 
of the skin, scald-head, and milk-crust or crusta lactea. 

The disease is likely to occur on any part of the body, but 
its favorite resorts are the scalp, behind the ears, face, fore- 
arms, and legs. The disease may be acute and chronic, and 
is sometimes a very stubborn case to cure, but all cases finally 
recover unless complicated by organic diseases. 

There are several varieties. Eczema simplex is charac- 
terized by a few spots caused by heat, and hence are called 
heat-spots. Eczema rubrum is a highly inflammatory variety 
with a burning sensation, and the formation of brownish scabs. 
This variety occurs in the flexures of the body in old persons ; 
it may attack the legs, and is called the weeping leg. It is 
often found on varicose legs, and may lead to ulcers. Eczema 
impetiginodes is the variety occurring in lymphatic children 
who are in the aplastic diathesis with a tendency to the for- 
mation of pus. It is a combination of eczema and impetigo, 
and is commonly seen on the heads of infants, and is called 
porrigo capitis, scald-head. 

Causes. — I think that the quickest way around this sub- 
ject is to say that we know but little about the cause. It is 
supposed to be in some measure of a hereditary tendency, but 
what causes that tendency we know but little. We know that 
the disease occurs as a rule in light-complexioned, pale, and 
ill-nourished children. It matters little, however, whether we 
know the cause or not so that we know how to cure the disease. 
Treatment. — In the first place we must put the child 
in as perfect a sanitary condition as possible, correct indiges- 
tion, and a want of assimilation, and remove all causes of 
irritation. 

Eczema Simplex. — Aconite is called for if the patient is 
feverish, but as a rule rhus tox. is the only remedy for the sim- 
ple variety of this disease. If it fails then cantharis or sul- 
phur will perform a cure. 



THEORY AND PRACTICE OF MEDICINE. 447 

Eczema Rubrum. — Antimonium tartaricum has red itch- 
ing rash over the body with vesicular eruption. 

Arsenicum. — Skin dry, scaly, with intense burning, or 
discharging corrosive ichor on face and extremities. In 
chronic cases I have seen the best results from 30X potency. 

Belladonna. — Skin red and hot, patient restless and sleepy, 
but can not sleep. 

Bovista. — Moist vesicular eruptions, with thick crusts 
about the mouth and nostrils. 

Conium. — Eruption about face, arms and mons veneris, 
especially in the old. 

Croton tiglium. — It is a well known fact that when a drop 
of croton oil is rubbed into the skin it immediately develops 
a case of eczema, and hence it is homoeopathic to that dis- 
ease when potentized. It is indicated for itching and painful 
burning, with redness of the skin, and formation of vesicles. 

Dulcamara. — Vesicles on face and extremities, oozing out 
of watery fluid, bleeding after scratching ; worse in the cold 
or in the evening. 

Graphites. — Eczema of the chin and behind the ears ; vio- 
lent itching and burning with eruptions. 

Eczema Impetiginodes. — In this condition we must look 
to the remedies that have a more direct influence over the 
scalp. 

Arsenicum. — Chronic eruptions on the scalp ; vesicles 
filled with pus. This remedy must be given high. 

Hepar sulphur. — Eczema spreading by means of new 
pimples appearing just beyond the old parts. Humid erup- 
tions on the scalp, feeling sore, of fetid odor ; itching vio- 
lently on rising in the morning ; burning and feeling sore on 
scratching. 

Lycopodium. — Eruption, beginning on the back of the 
head ; crusts thick, easily bleeding, oozing a fetid moisture ; 
worse after scratching and from warmth. 

Mercurius corrosivus. — Burning, redness of the skin, with 



448 THEORY AND PRACTICE OF MEDICINE. 

formation of small vesicles ; severe and stubborn eczema, 
with much itching. 

Sulphur. — Eczema itching violently, and having a ten- 
dency to spread, though situated chiefly on the head or vulva. 
It is said that the disease scarcely ever returns when cured by 
sulphur, especially if the higher potencies have been used. 
In chronic cases I always begin with the thirtieth potency, and 
find better results than from any other. 

Vinca. — Eczema of scalp and face, crusta lactea, with offen- 
sive odor, and matting the hair together. 

Viola tricolor. — Allen gives the following clinical history 
of this drug. Eczema of scalp, with swollen cervical glands. 
In crusta lactea it is similar to vinca — but viola has urine like 
cat's urine. By some considered nearly specific in eczema of 
the scalp, especially with matted hair. 

The patient should be kept clean, and as he is in the aplas- 
tic diathesis, should have animal food and such things that 
restore the normal diathesis. The parts should be washed 
with pure soft water, and an unirritating soap. If the crusts 
are thick and accumulation of fluid or pus beneath, then they 
should be soaked with tepid water or a mild poultice until 
they are softened, and easily come away by washing. The 
parts should be thoroughly dried with a soft cloth, but not 
rubbed, and then dusted with the compound sterate of zinc, 
this soothes the itching and stops the desire to scratch. I 
have used carbolized water, solution of calendula, and very 
dilute solution of croton tig., but I have found nothing to equal 
the zinc mentioned above. 

If the itching is not intense then external applications 
should not be used, and trust wholly to internal remedies. 
One thing, however, is certain, that if something is not done 
to prevent the child from scratching the head until the scalp 
is a raw bleeding sore every morning, then no medicine can 
be expected to cure. 



THEORY AND PRACTICE OF MEDICINE. 449 

HERPES. 

SHINGLES. 

This disease belongs to the class of skin eruptions, called 
vesicular. It is called shingles because it has a tendency to 
spread around the body like a girdle. It is also called herpes, 
from herpo, I creep along, that is, spreading vesicles. 

Symptoms. — The patient feels languid, feverish and 
pain in the left side, with patches of vesicles looking like 
drops of water. In four or five days the serum is partly ab- 
sorbed and the vesicles turn dark. 

As the disease is found in different portions of the body, 
and assumes different shades, it is called by different names. 
Herpes phlyctenodes is that variety which has no particular 
seat. They usually occur on the face, neck, and upper limbs. 
They form in patches as large as a nickel, or silver quarter, 
they are surrounded by a red areola. Herpes labialis occurs 
on the lips, and may extend to the nose, cheeks, chin and 
mucous membrane of the mouth. Herpes preputialis if found 
on the external or internal prepuce, and has an itching and 
smarting sensation. Herpes zoster, zona or the shingles. 
This usually occurs on the left side and produces pain simi- 
lar to that of pleurodynia. The disease is apt to spread 
around the body, and the zona as it is called is dreaded by 
many, for it was once supposed that when the zones met, the 
patient would die ; this, however, is an error. Herpes circin- 
natus, arranged in rings, with a red border, and a center of 
sound skin. Herpes iris, a rare variety, appearing in round 
groups and consisting of four rings of different shades of 
color. 

Causes. — Anything that may cause an irritation of the 
nervous system and indigestion. 

Prognosis. — Favorable, unless some organic disease is 
associated with herpes. It usually lasts from seven to twenty- 
one days. 

29 



450 THEORY AND PRACTICE OF MEDICINE. 

Diagnosis. — When we remember that it belongs to the 
vesicular class, eczema is the only disease which may confound 
us. But the vesicles of herpes are larger than those of eczema, 
and do not tend to be confluent, while eczema forms raw and 
moist crusts. 

Treatment, — In the beginning of all varieties of herpes 
if the patient is feverish then aconite must be given. 

Cistus canadensis. — Herpetic eruption on various parts. 

Iris versicolor. — Irregular patches on knees, elbows and 
body. 

Phosphorus. — Vesicles around joints. 

Treatment of Herpes Circinnatus. — Tellurium for 
ring-worms ; covering the whole body, more distinct on lower 
limbs ; on single parts. 

Treatment of Herpes Zoster. — Arsenicum, when 
there is herpetic eruption, itching and burning. 

Cannabis saliva. — Itching vesicles on head and chest filled 
with serum, and surrounded by red areola ; burning when 
touched. 

Iris versicolor. — Herpes zoster on right side of the body. 

Ranunculus bulbosus. — Vesicular eruptions, as from burns, 
shingles and intercostal neuralgia. 

Rhus toxicodendron. — Herpetic eruption with incessant 
itching, burning and tingling, alternates with pains in chest 
and dysenteric stools, zona. 

Zincum. — Neuralgia, from herpes zoster ; by painting the 
vesicles with tincture of iodine morning and night, and letting 
the paint lap on to the sound skin an inch or so will prevent 
the spread of the disease and cause the vesicles to dry up sooner. 

If the parts are very sore and tender vaseline and a soft 
cloth may be applied. 




THEORY AND PRACTICE OK MEDICINE. 451 

SCABIES. 

ITCH. 

This is a vesicular contagious disease, appearing as a rule 
between the fingers, and then on the wrists, inside of the fore- 
arm, and at the bends of the joints. It causes intense itch- 
ing and burning after scratching. I have seen the hands so 
stiff that the fingers could scarcely bend. The disease is 
caused by the itch-insect, called sarcoptes scabies. I have 
picked them from matured vesicles and viewed their form 
and movements with the naked eye. 

Treatment. — Sulphur internally, and sulphur oint- 
ment externally, usually cures. It is supposed that the 
sulphur and lard combined destroy the itch-insect. The parts 
should be bathed in warm water and soap, and rubbed with 
a coarse towel before applying the ointment, so that it may 
come in direct contact with the insects. The ointment should 
be rubbed in well and left on over night, and the patient take 
a warm water and soap-bath in the morning, to cleanse the 
skin from sulphur. 

As it takes so long to get rid of the odor of sulphur oint- 
ment, I have used an ointment of sulphuric acid and lard, say 
five to fifteen drops of the acid to an ounce of lard. Care 
must be taken not to get it too strong, or the acid will not 
only exterminate the insect, but prove an escharotic to the 
sound skin. The vesicles must be touched lightly, so as to 
test the strength of the ointment, and when of proper strength 
it cures with one or two applications. When applied at 
night, an old garment must be worn, for the acid destroys the 
clothing if it is too strong. The parts should be washed 
with warm water and soap in the morning, and the patient is 
usually well in a few days. It is said that an ointment com- 
posed of five to ten grains of cuprum to an ounce of lard, 
relieves the most inveterate itch. When the itch returns 
after being suppressed by the sitlphur ointment, sepia will ar- 
rest its action. 



452 THEORY AND PRACTICE OF MEDICINE. 

BULLAE. 

The next classification of skin diseases is called bullae, 
which comes from the latin word bulla, a water bubble. 
Bullae, as collections of serous fluids of considerable size, are 
situated immediately beneath the cuticle, and rising from the 
true skin. They differ from vesicles only in size ; and no very 
definite line can be drawn between a large vesicle and a small 
bulla. They usually vary in diameter from a quarter of an 
inch to two inches. They constitute a special order of skin 
diseases, which includes pemphigus and rupia, and are thus 
classified. 

-p> f Pemphigus. . . .Vesicular Fever. 
\ Rupia Atonic Ulcers. 

PEMPHIGUS. 

VESICULAR FEVER. 

The term bleb is of the same import of bullae, and has 
reference to large vesicles or blisters. There are three varie- 
ties of blebs recognized under the terms pemphigus and rupia. 
i. The mild blebs, which vary in size from a pea to a hazel- 
nut, occur on the face, neck, or arms, and legs of teething 
infants, and young persons who have indulged in unripe fruit. 
They generally burst, discharge the clear fluid they contain, 
and heal up in three or four days. 2. The tedious blebs, 
which commonly affect aged and weakly persons, are seen as 
an eruption of numerous red elevations, which enlarge to the 
size of a pea, containing pale yellow serous fluid. The vesi- 
cles multiply to such an extent that the sufferer is disturbed 
at night from the irritation, and slight febrile attacks further 
debilitate him. 3. The solitary bleb generally selects old 
women for its victims, and appears, after much tingling of the 
skin, as one large vesication, and bursts in forty-eight hours, 
leaving a superficial sore. 

Causes. — Adult and old age ; summer seasons ; excit- 
ing causes which induce the aplastic diathesis. 



THEORY AND PRACTICE OF MEDICINE. 453 

Diagnosis. — From vesicular eruptions, by larger size 
and less clustered form of the vesicles. From rupia, by the 
absence of thick scabs. From ecthyma, by the contents of the 
vesicles being- transparent. From erysipelas, by the irregular 
vesicles of the latter appearing on a highly inflamed surface, 
which is constantly spreading. 

The prognosis is favorable, but the disease may last long. 

Treatment. — Aconite must be given when the patient 
is feverish. 

Cantharis. — The large blisters of pemphigus with burning 
sensation call for cantharis. 

Phosphoric acid. — This remedy is called for when the vesi- 
cles or blisters are large, bursting and leaving surface ex- 
coriated. 

Ranunculus bulbosus. — Pemphigus, vesicular eruptions 
large. 

Rhus tox. — This remedy is homoeopathic to almost every 
form of skin-disease of the vesicular variety ; pemphigus, each 
bulla with a red areola. 

If the eruption is irritable vaseline may be applied from 
time to time. 

RUPIA. 

ATONIC ULCER. 

Dermatologists have given several varieties of this disease, 
but for all practical purposes we mention but three. 

Symptoms. — In its simplest form, the blebs are not pre- 
ceded by inflammatory symptoms, are about an inch in diame- 
ter, and contain a fluid which is originally thin and transpa- 
rent, but soon thickens, becomes purulent, and dries into brown 
ragged scabs, elevated in the centre. The scabs are easily 
separated, and leave ulcerated surfaces, on which several suc- 
cessive scabs usually form before healing. 

Rupia Prominens. — In this severer form the scab pro- 
jects so much in the centre as to resemble the appearance of 
an oyster shell in miniature. 



454 THEORY AND PRACTICE OF MEDICINE. 

Rupia Escharotica affects infants in the interval from 
birth to the first dentition. 

Rupia is a chronic disease, usually limited to the limbs, 
the loins, and the nates. It is not contagious, and generally 
attacks persons debilitated by old age, intemperance, bad liv- 
ing, or previous diseases. 

Diagnosis. — From pemphigus, by the thick laminated 
scab, the inflammatory areola, and subsequent ulceration. 

Treatment. — Arsenicum, aiirum metallicum, iodine, 
kali iodatu?n, mercurius, nitric acid and other remedies may be 
indicated from time to time. 

The ulcers may be cleansed with calendula lotion of tepid 
water, or carbolic acid lotion is sometimes highly beneficial. 
The parts may be washed with soap and water, and after 
gently drying dust with the compound sterate of zinc. 

The pustular classification may be seen in the following 
table : 



Pustules. 



r Ecthyma .... 

Impetigo . . . Running Tetter. 

Acne Copper-Nose. 

Mentagra . . .Tinea Sycosis. 

Porrigo .... Tinea. 
L Equina Glanders. 



ECTHYMA, 



Symptoms. — The eruption begins in the form of dis- 
tinct inflamed circumscribed spots, which increase till they 
attain a considerable size. Pustules form on the center, and 
sometimes increase in size till they bear a close resemblance 
to the large bullae of rupia. In two or three days the pus- 
tules dry up, leaving behind them thick scabs, and these fall- 
ing off, leave a purple discoloration of the skin, or in severe 
cases, unhealthy ulcers. 

Diagnosis. — From acne, impetigo, sycosis, and porrigo, 
by the larger size of the pustules, and their inflamed and in- 



THEORY AND PRACTICE OF MEDICINE. 455 

durated base. From variola, by their size and the absence of 
the central depression. 

Treatment. — Antimonium tartaricum is indicated 
when pustular eruptions leave bluish-red marks ; thick erup- 
tion, like pocks, often pustular as large as a pea. 

Arsenicum. — This remedy is indicated for burning pus- 
tules in broken-down constitutions. 

Mercurius. — Pustules sometimes running together ; form- 
ing dry scaly spots, or crusts, and acrid discharge. 

Rhus tox. is often indicated. 



IMPETIGO. 

RUNNING TETTER. 

This is characterized by clusters of pustules, which may 
either be scattered or in groups. There are several species. 
Impetigo figurata, occurs most commonly on the cheeks of 
young children during the spring months. Impetigo sparsa 
appears on the extremities and around the joints, and usually 
occurs in the autumn. Impetigo larvalis is common to in- 
fants and its usual seat is the scalp, ears and lips. Impetigo 
granulata is characterized by a number of whitish-yellow 
pustules, containing a single hair ; it is accompanied by in- 
flammation and itching. The pustules burst in from two to 
four days, leaving rough brownish crusts, with a disagreeable 
odor. 

Diagnosis. — The pustules appearing in clusters distin- 
guish impetigo from the other pustular diseases. 

Treatment. — Antimonium crudum, antimonium tar- 
taricum, arsenicum and kali bichromicum, will usually be suffi- 
cient to cure. 

The parts must be kept clean and dusted with the com- 
pound sterate of zinc. 



456 THEORY AND PRACTICE OF MEDICINE. 

ACNE. 

COPPER-NOSE. 

As this disease was so frequently seen on the nose, the old 
writers called it copper-nose. It occurs on the cheeks, tem- 
ples and forehead, and often occurs on the shoulders. It is 
placed by some dermatologists in the order pustulse, and by 
others in the order tubercula, which includes solid, hard ele- 
vations of skin, much larger than papulae. As acne has at 
some of its stages the pustular form, though it may be slight, 
I have placed it in the order of pustules. It is not rare to find 
on the face and shoulders of young persons about or above the 
age of puberty a number of black spots, each of which is placed 
on a slightly raised pale base. These black points are called 
comedones. Pressure at the base occasions the expulsion of 
a little elongated, spiral, white mass,, with a black point or 
anterior end, commonly but erroneously regarded as a worm. 
In the midst of the white mass of sebaceous matter, a parasite, 
acarus folliculorum is, however, often found. When the pus- 
tule is the most striking feature, the affection is called acne 
simplex or vulgaris ; when the black points abound, it is acne 
punctata ; and when there is decided induration, it is acne in- 
durate. This affection is never seen in children ; and is rare 
in aged persons. Acne rosacea, usually appear first at or near 
the end of the nose ; in some cases confined to the nose, in 
others extending to the cheeks, forehead, chin, or even to the 
whole face. The skin in the part affected assumes a deep-red 
color, pustules of acne occur. The disease is confined almost 
exclusively to persons in middle or advanced life, and women 
are liable to it about the period of the change of life. The 
face is sometimes disfigured with redness and dotted with 
pustules. 

Diagnosis. — The location, the small-sized pustule on a 
hardened base will distinguish acne from all other forms of 
skin disease. 

Prognosis. — The simple variety often gets well with- 



THEORY AND PRACTICE OE MEDICINE. 457 

out any treatment, while acne indurata is often very ob- 
stinate. 

Treatment. — Belladonna is indicated for acne punc- 
tata, with bright red pimples, in plethoric persons, with scar- 
let flushings. 

Baryta carb. — Black spots or comedones. 

Borax veneta. — Unhealthiness of the skin ; red papulous 
eruption on the cheeks. 

Treatment of Acne Indurata. — Antimonium crude, 
arnica, calcarea carb., clematis erecta and conium, are all rec- 
ommended for this condition. 

Iodine. — This is strictly homoeopathic to acne. Hebra 
states that many persons, if they take iodine internally, are 
affected with an outbreak of numerous papules of acne on the 
face, chest and back, which in some cases quickly change to 
pustules. 

Juglans regia. — Comedones and acne of the face. 

Kali bromicnm. — Acne on the forehead and cheeks ; acne 
pimples, with yellow tips. This remedy in crude doses has 
produced an eruption of acne, and hence it is homoeopathic. 

Treatment of Acne Rosacea. — For the red nose and 
red blotches and acne on the face, I have been able to relieve 
nearly all cases with belladonna 30X. 

Pulsatilla. — Acne rosacea, due to indigestion and deranged 
menses. 

Rhus tox. — This remedy is indicated in almost all pustular 
diseases and especially for acne rosacea. 

riENTAQRA. 

TINEA SYCOSIS. 

This is a disease affecting the beard, mustache, whiskers, 
and inner part of the nostrils — caused by minute fungi, or 
vegetable parasites, at the roots of the hair. It is called bar- 
ber's itch, because it is supposed that it is communicated by 
the barber's razor. It is also called chin-welk. Dr. Fox, the 



45$ THEORY AND PRACTICE OF MEDICINE. 

dermatologist, holds that sycosis is a parasitic disease, there- 
fore he called it tinea sycosis. 

Symptoms. — The affection first makes its appearance 
on the chin or upper lip, the parts become red, itchy, with lit- 
tle elevations, which in a few days ripen into distinct pointed 
pustules, traversed by a single hair. After a few days the 
pustules burst, and form thin brownish scabs. When the dis- 
ease is of long standing the beard falls off. 

Diagnosis. — The location of the pustules at the root of 
each beard leave no doubt as to the distinction of the disease. 

Treatment. — Antimonium crudum produces pimples, 
pustules, boils on the face, eruptions with thick, hard scabs. 

Graphites. — Humid pimples on the face ; hair of the whis- 
kers or beard falls out. 

Mercurius. — Suppurating pustules sometimes running 
together, forming dry scaly spots or crusts. 

Sulphur. — This remedy is called for in nearly all diseases 
of the skin. 

If tinea sycosis is due to a parasite called the microsporon 
mentagrophytes, or the demodex folliculorum, then the sul- 
phuric acid ointment recommended for the itch-mite will cure 
mentagra. 

PORRIGO. 

TINEA. 

Formerly this was treated as a separate disease, but now it 
is bewildering to try to follow modern writers on the subject, 
we are referred to favus, or porrigo larvalis, porrigo capitis, 
scald-head, impetigo, or running tetter, eczema and ring-worm. 

There are three forms of ring- worm described under the 
head of porrigo or tinea, i. Ring-worm of the body — tinea 
circinnatus. It appears as a rose-colored and slightly elevated 
spot about the size of a half-dime, on which a brand-like des- 
quamation of epidermis soon begins, accompanied by slight 
itching. The disease heals in the center and spreads in a cir- 



THEORY AND PRACTICE OF MEDICINE. 459 

cular form until it often reaches a diameter of four inches. It 
may occur on the face, neck, back, and outside of wrist. 2. 
Tinea tonsurans, or ring-worm of the scalp. This occurs in 
children, and appears in round, scaly, irritable patches on dif- 
ferent parts of the head ; they retain their circular form. The 
hair in the center of the rings dies and leaves the parts bald. 
3. Tinea sycosis, or ring-worm of the beard. This occurs 
chiefly on the skin, hairy part of the cheeks, and upper lips of 
men ; but it occurs in the axillae and pubic region of women. 
It takes the usual course, but when the deeper structures be- 
come affected, pustular indurations, resembling acne, occur, 
and the hairs become readily detached. On examining the 
hairs under the microscope, it is seen that they are thickened, 
that their bulbs are partially disorganized, and that the 
medullary portion is atrophied. 

Diagnosis. — The clustered pustules, the rough-pitted 
scab, and the circular form of the disease, distinguishes if from 
other pustular affections. 

Treatment. — The remedies given under the other pus- 
tular diseases must be used for porrigo or ring-worm. 

Iris has pustular eruption on scalp, face, around mouth. 

Rhus tox. — Eruption suppurating, moist, forming thick 
crusts, hair eaten off. 

Sepia. — Humid tetter, ring-worms, pustules, pemphigus ; 
eruptions on scalp and behind ears. 

Sulphur. — Humid, offensive eruption on the head with 
yellow crusts ; intertrigo, acne, eczema, herpes, in short all 
forms of skin eruption. I have found 30X to act better than 
anything lower. 

Tellurium. — Ring-worms over whole body, more distinct 
on lower limbs ; vesicles in clusters on an inflamed base on 
forehead ; the herpetic spot was circular, about half an inch in 
diameter, consisting of an elevated ring of vesicles, some 
larger than others, on an inflamed base, enclosing a depressed 
area of red skin, which desquamated but contained no vesi- 
cles ; it itched and had successive crops of thin white scales. 



460 THEORY AND PRACTICE OF MEDICINE. 

Viola tricolor or jacea. — Tinea capitis, impetigo of the 
hairy scalp and face ; squamous spots on the skin. 

EQUINIA. 

GLANDERS. 

This is an infectious disease and, as its name implies, 
mostly affects horses, but may be communicated to man by 
inoculation through the mucous membrane, and runs a sim- 
ilar course to that in animals. When nodular growths ap- 
pear in the nose, it is called glanders ; if in the lymphatic 
structures, it is called farcy. 

Drs. Goodno, McKenzie, Oster and others, have reported 
cases which came under their observation. Fortunately, 
the disease is rare in man. Those who have had it com- 
plained of pain in the head, back, and limbs ; nausea, thirst, 
great prostration of strength, and stiffness and pain in the 
joints, increased by motion. After a short time there is red- 
ness, heat, swelling, and excoriation of the nose, lips and 
cheeks ; the eyes are inflamed, and the eyelids swollen ; 
there is a profuse discharge of yellow or sanious fluid from 
the nostrils ; and pustules appear on different parts of the 
body. These local symptoms are accompanied by a hot 
skin, urgent thirst, frequent, weak and irregular pulse, and 
feeble respiration. These symptoms increase in severity, and 
followed by diffused abscesses in different parts of the body, 
especially about the joints ; the nose and lips become gan- 
grenous ; the discharges extremely offensive, low muttering 
delirium sets in, and death takes place by collapse. 

Farcy is a disease in horses allied to that of the glanders, 
which it usually precedes and accompanies. The absorbent 
glands and vessels, usually of one or both hind limbs, are in- 
flamed, tender, swollen, hard, and knotted. The vitiated 
lymph thus poured out softens, and ulcers, or farcy buds, 
appear. 

Diagnosis. — The seat and character of the pustules, 



THEORY AND PRACTICE OF MEDICINE. 461 

and history of the case, render the diagnosis comparatively 
easy. 

Prognosis. — Is very unfavorable. 

Treatment. — Dr. Goodno recommends the excision or 
destruction of the infected spot. From my experience in snake 
bites and infectious poisons, I should recommend the applica- 
tion of the compound tincture of iodine, and a hypodermic in- 
jection of an aqueous solution of iodine near the seat of infec- 
tion. For hypodermic use the addition of iodide of potash to 
the iodine, causes the latter to be more soluble. The antidotal 
power of iodine over infectious animal poisons is not suffi- 
ciently appreciated by many of the medical fraternity. 

Aconite, arsenicum, crotalis, graphites, and kali bichromi- 
cum, are mentioned by different writers as giving some hope 

of cure. 

{Strophulus. . . . Red Gum. 
Lichen 
Prurigo Pruretus. 

STROPHULUS. 

RED-GUM. 

This is a disease of dentition and is often called tooth-rash. 
It is a florid eruption, and usually appears on the face, neck, 
arms, and hands. Red strophulus or red-gum occurs in mi- 
nute red pimples, irregularly placed, with occasional red patch- 
es, and sometimes a few interspersed vesicles. White-gum 
consists of pearly white, opaque pimples, smaller than the 
red, and usually about the size of a pin's head. 

Causes. — -Unwholesome diet, and child kept too warm. 

Treatment.— The first and most important thing to be 
done is a change of the child's diet and sanitary surroundings. 

Antimonhim crttdum. — Pimples like nettle-rash. 

Apis. — White miliary eruption on chest and abdomen. 

Arsenicum. — Pimples resembling red petechias, from the 
size of a flea-bite to that of a lentil. 



462 THEORY AND PRACTICE OF MEDICINE. 

Belladonna. — This is our main reliance for all red rashes 
and pimples. 

Chamomilla. — Red rash on the cheeks. 

LICHEN. 

This disease belongs to the papular variety of skin diseases. 
Some authors have classified lichen and strophulus under the 
same head. While it is true that some forms of strophulus 
and lichen resemble each other very closely yet there is a 
difference. 

While some writers have given several varieties of lichen, 
yet some of them are only a commingling of symptoms of the 
other papular diseases, hence we have but two forms of lichen. 

1. Lichen simplex consists in an eruption of minute papulae 
of red color, which never contain a fluid, and are distributed 
irregularly over the body. They appear first on the face and 
arms, then extend to the trunk and lower extremities, and are 
accompanied with a sense of heat, itching, and tingling. In 
a mild case, the disease is over in a week, but sometimes one 
crop of papulae succeeds another for many weeks or months. 

2. Lichen agrius, in this form the papulae are more pointed 
at the summit, and are of a bright-red color, with more or less 
redness extending round them. In this form of the disease, 
the general health is usually affected, in consequence of loss 
of sleep and general irritation. Lichen is non-contagious and 
not dangerous, but often troublesome to cure. 

Treatment. — Antimonium crtidum, apis, arsenicum, 
ledum palustre, mix juglans and sulphur are usually the in- 
dicated remedies. 

PRURIGO. 

PRURITUS. 

This is a papular affection characterized by intense itch- 
ing in which the papulae are of the color of the skin ; larger 
than those of lichen. There are three forms : 1. Prurigo 



THEORY AND PRACTICE OF MEDICINE. 463 

mitis, presents a smaller sized pimple than the other varieties, 
and is attended with less itching; 2. Prurigo formicans, has 
not only intense itching, but patients complain of a feeling 
like the creeping of ants — hence the specific name — or the 
stinging of insects, or as if hot needles were thrust into the 
skin. The itching is greatly increased by the warmth of the 
bed ; 3. Prurigo senilis or pedicularis is characterizd by the 
presence of large numbers of minute insects, and is accom- 
panied by greater dryness of the skin. 

Diagnosis. — From lichen, by the large size of the pim- 
ples, by the dark spot on their surface, and by the more severe 
itching. 

Treatment. — All medicines which in their physiologi- 
cal action on the skin produce intense itching, papular erup- 
tions, are homoeopathic to prurigo. I will only mention a few. 

Aconite. — Intense itching of the skin with heat or feverish 
symptoms. 

Apis. — Stinging, crawling, itching and burning sensation. 

Arsenicum. — Burning itching, parts painful after scratch- 
ing. 

Aurum metallicum. — Violent itching over whole body from 
evening till midnight. 

Capsicum. — Itching worse from scratching. 

Carbo animalis. — Itching over whole body in bed. 

Cistis canade7isis — Itching over whole body. 

Conium. — Erratic itching on all parts of the body. 

Cuprum metallicum. — Unbearable itching, measle eruption 
develops. 

Mercurius. — Itching all over, worse at night when warm 
in bed. 

Mezereum. — Violent itching, worse in bed, pruritis senilis, 
intolerable itching. 

Rhus tox. — Itching all over, worse in hairy parts ; after 
scratching, burning. 

Sulphur. — Voluptuous itching and tingling, with burning 
or soreness after scratching; itching worse in warm bed. 



464 THEORY AND PRACTICE OF MEDICINE. 

We next take up the subject of scale diseases which are 
thus classified. 

{Psoriasis Lepra Vulgaris. 
Pityriasis .... Branny Tetter. 
Ichthyosis .... Fish Skin. 



PSORIASIS. 

LEPRA VULGARIS. 

This is a non-contagious scaly disease, and is called by some 
dry tetter. 

Symptoms. — This is a chronic disease characterized by 
white scales, and of different varieties. Psoriasis guttata de- 
rives its name from the scales not coalescing. It begins with 
round red patches. Psoriasis diffusa spreads over large por- 
tions of the skin, and often renders the patient hideous to look 
at, the scaly incrustations being interspersed with bleeding 
fissures. Psoriasis inveterata, merely the severe phase of the 
preceding form, occurring in aged broken-down constitutions. 
Psoriasis gyrata, a rare form, occurring in narrow strips or 
rings. 

Causes. — Abuse of spirituous liquors, pork and un- 
wholesome food. It is also hereditary. 

Prognosis. — It is free from danger but obstinate to cure. 

Treatment. — Arsenicum is the remedy par excellence, 
and in my first experience I failed to cure the disease because 
I gave the remedy too low. I am now curing nearly all cases 
with the 30X by the help of sulphur — 30X as an intercurrent 
remedy. 

Hydrocotyle. — Dr. Allen says that this remedy has cured 
psoriasis with great thickening of the epidermoid layer, and 
enormous exfoliation of scales. 

Iris. — Irregular patches on knees, elbows and body, with 
shining scales, the edges slightly raised. 

Mercurius. — This is indicated where the skin is rough 
with dry scaly spots, sometimes of a yellowish cast. 



THEORY AND PRACTICE OF MEDICINE. 465 

Mezereum. — Scurf -like fish-scales on back, chest, thighs 
and scalp. 

Petroleum. — Obstinate cases ; scaly patches with deep 
fissures. 

Sulphur. — Skin rough, scaly and scabby. 

Teucriiim marum verum. — Psoriasis ; dry scruffy erup- 
tions ; scaly tetter on lobule of right ear, then desquamation 
of white scales, the ear sore and painful to touch. 

PITYRIASIS. 

BRANNY TETTER. 

This disease is characterized by desquamation of the cuti- 
cle, on different parts of the body, and is sometimes called 
dandruff. 

Symptoms. — The disease begins with slight irritation 
and itching of the skin. Pityriasis capitis occurs on the head 
of new born infants, and at all ages, and the white bran-like 
scales are called dandruff. Pityriasis rubra, as its name im- 
plies, has red colored spots. In pityriasis versicolor, the skin 
is yellow instead of red. Pityriasis nigra is characterized 
by a dark color of the skin. 

Treatment. — Arsenicum high is almost specific. 

Graphites, lycopodiiun, sulphur, may be indicated in some 
cases. I have found rose-water containing a few drops of 
carbolic acid to be an excellent dressing for the head, to pre- 
vent dandruff from returning. 

ICHTHYOSIS. 

FISH-SKIN. 

This is a disease, as its name implies, in which scales form 
and overlap each other, resembling fish-scales. They may 
occur over any part of the body, but more generally on the 
palms of the hands, soles of the feet, face, eye-lids. There is 
no pain, or itching, but often a disagreeable odor arises from 
the parts. 

3° 



466 THEORY AND PRACTICE OF MEDICINE. 

Treatment.— Arsenicum is usually sufficient to arrest 
the disease. 

Mezereum. — Hair covered with scurf, hair comes out in 
handf uls ; scurf-like fish-scales on back, chest, thighs and 
scalp. 

{Lepra Tuberculosa . . . Elephantiasis. 
Lepra Graecorum Leprosy. 
Frambcesia The Yaws. 
Molluscum 
Lupus Wolf. 



LEPRA TUBERCULOSA. 

ELEPHANTIASIS. 

We must ever keep in mind the distinction between lepra 
elephantiasis, and elephantiasis grsecorum, for they are two 
distinct diseases. The latter is true leprosy. Elephantiasis 
causes a hypertrophied condition, which looks and feels some- 
what like elephant's hide. In very severe cases the tubercles 
become inflamed and ulcerated and discharge an offensive 
sanies, which concretes into black scabs. 

Treatment. — The congenital elephantiasis is rarely 
ever cured, but other cases are amenable to treatment. 

Arsenicum. — May be of much service by long continued 
use. 

Hydrocotyle. — Allen says that this remedy has ameliorated 
cases of elephantiasis. 

LEPRA QRAECORUM. 

LEPROSY. 
There is a discrepancy among writers as to this affection, 
owing to the fact that two diseases have been described under 
the head of lepra. It is probable that the ancients confounded 
lepra elephantiasis with lepra verse, which is true leprosy. 
There are two varieties of leprosy ; tubercular leprosy is 
characterized by tumefaction of the skin, in shining or 



THEORY AND TRACTICE OF MEDICINE. 467 

bronzed dark -brown patches, and often excessively tender. 
Non-tubercular anaesthetic leprosy is characterized by light 
discolored patches, devoid of sensation, on the face, ears, and 
extremities ; bullae atrophy ; distortion of the fingers and toes 
by contraction, which gives them the appearance of bird's 
claw, rather than by the ulcerative process. 

Dr. Copeland gives the following symptoms of this disease : 
Dusky red or livid tubercles of various sizes on the face, ears, 
and extremities ; thickened or rugose state of the skin, a 
diminution of its sensibility and falling off of the hair, except- 
ing that of the scalp ; hoarse, nasal, or lost voice ; ozaena ; 
ulcerations of the surface and extreme fetor. These tuber- 
cles vary in size from that of a pea to an olive. Of all parts, 
the face is particularly affected, especially the nose and ears. 
Causes. — Nothing certain is known regarding the cause 
of leprosy. The investigations of Stewart at Tranguebar, 
where it is very prevalent, led him to conclude : 1. That 
women are less liable to it than men ; 2. That it is heredi- 
tary ; 3. That its contagiousness is extremely doubtful; 4. 
That a fish-diet renders every symptom worse ; 5. That poor 
living, want of cleanliness, and exposure to cold and damp, 
are constant attendants. Dr. Copeland ascribes its origin to 
the use of semi-putrid meat, and fish, and rancid oils ; to in- 
sufficient vegetable food ; and to the contact of matter dis- 
charged from leprous sores. 

Treatment. — Arsenicum is an invaluable remedy. 

Hydrocotyle.- — The late provings of this agent have shown 
that it is homoeopathic to leprosy. It has ameliorated cases 
of leprosy — seems to have arrested the destructive processes. 

Gurjun or wood oil. — Dr. Dongall, of Port Blair, An- 
daman Islands, reports twenty-four cures by this remedy. He 
believes that leprosy, both tubercular and anaesthetic, can be 
arrested by this remedy. He used an ointment, externally, 
composed of one part of the oil, to three of lime-water, shaken 
until an emulsion was formed. He rubbed the ointment in 
thoroughly, then covered the parts with finely-powdered clay, 



468 THEORY AND PRACTICE OF MEDICINE. 

then finally washing it off in a stream. After drying the 
skin, the ointment was again applied. He states that in no 
case have the ulcers returned. He gave the medicine inter- 
nally at the same time he was using it externally. He used 
equal parts of the oil and lime-water ; of this he gave four 
drachms morning and night. It is to be hoped that his 
treatment may prove a success in the treatment of the dreaded 
leprosy. 



FRAMBCESIA. 

THE YAWS. 

This is an African name of a raspberry, or a tubercle re- 
sembling a raspberry. Yaws is technically known as fram- 
bcesia, commonly attacks negroes, but has been noticed in 
Europeans. 

Symptoms. — The disease is in the form of clusters, of 
variable size and shape, of small, dark-red spots, resembling 
flea-bites. Upon these spots papulae are developed, which 
degenerate into indolent vegetations resembling, when they 
are found in circular groups, raspberries or mulberries. These 
vegetations are firm, slightly inflamed, and covered with thin 
dry scales. In some instances, they become the seat of ulcer- 
ation, and of a yellow or bloody discharge, which concretes 
into scabs. 

Causes. — Contagion, occurring in the West Indies, parts 
of America and Africa. 

Prognosis. — Favorable, but when chronic often lasts 
for years. 

Treatment. — Arsenicum. — Eruption resembling red 
petechise, turning dry and scaly. 

Aurum. — Small and large blotches, stinging, burning, 
feeling like hard knots, of a dirty-yellow color. 

Lachesis. — Bullae dark from bloody serum within, malig- 
nant pustule. 



THEORY AND PRACTICE OF MEDICINE. 469 

Nitric acid. — Skin dark, dirty; brown-red spots, condylo- 
mata moist, like cauliflower, or in thin pedicles. 

Thuja. — Bleeding fungus growths, wart-like tubercles. 

While I have never known of its being tried in yaws, yet 
from its effect on syphilitic excrescents I believe that the ap- 
plication of the tincture of thuja would hasten the cure. 

MOLLUSCUn. 

This is a disease characterized by numerous indolent 
tubercles, ranging from the size of a pea to that of a pigeon's 
egg, of the natural color of the skin, containing a curdy mat- 
ter ; there is no pain or ulceration. They may occur on any 
part of the body, appearing at first in childhood and often con- 
tinue through life. 

Treatment. — Arsenicum is considered a good remedy 
in this disease, but it must be continued for a long time. 

Iodine and biniodide of mercury are valuable agents. In 
other words molluscum must be treated upon the same gen- 
eral principles as that of scrofula of the glands. 

LUPUS. 

WOLF. 
This disease is characterized by the development of tuber- 
cles and destruction of tissues. Owing to its destructive 
nature of the tissues of the face, mouth, nose, and the hideous 
appearance of the naked teeth, bones of the face and nose, the 
disease is called lupus, a wolf. There are two varieties. 1. 
Genuine lupus, herpes exedens, or noli metangera. 2. Lupus; 
non exedens. 

Symptoms. — In lupus exedens a portion of the skin of 
the face, near the alae-nasi, inflames, swells, arid becomes of 
a bright red tint. The swelling frequently occurs in the form 
of one or more tubercles ; not however indurated like scirrhus. 
After a time, a painful, foul, excavated ulcer forms ; variable 
in its progress, sometimes stationary, or partially cicatrizing^ 



470 THEORY AND PRACTICE OF MEDICINE. 

but in the end destroying the flesh of the nose and cheek ; 
causing caries and exfoliation of the bones ; till the patient, a 
horrid spectacle, dies worn out with pain, his eye dropping 
from its socket into the chasm made by the destructive cheek. 
This affection mostly occurs to adults ; especially if of weakly 
scrofulous habit ; vitiated by intemperate habits. 

The lupus non exedens is a milder form, and attacks scro- 
fulous children. It begins, with shining tubercles, which 
ulcerate ; but the ulceration has a tendency to spread widely, 
rather than deeply ; causing prodigious deformity by the suc- 
cessive ulceration and puckered cicatrization of the face. 

Prognosis. — Favorable when observed early, but when 
it becomes chronic it is unfavorable. 

Treatment. — Dr. Franklin says that arsenicum is the 
most valuable remedy that he has used in the treatment of 
both varieties of lupus. Mercurius biniodide is also a valu- 
able remedy. Causticum, cicuta, carbolic acid, Hydrastis, kali 
hydriodicum, iodine, iodide of arsenic, Phytolacca, and sulphur 
are all recommended, but I have but little faith in any except 
arsenicum, iodide of arsenic, and iodide of mercury. I think 
that a wash of carbolized warm water, would be soothing, and 
I should expect good results by the application of the iodide 
of sulphur ointment. 

Several cases of lupus are said to have been cured by the 
hypodermic injection of Kocli's turbercular ly7tiph. 

MACUL/E. 

SPOTS. 

To this class of skin diseases belong the common freckle- 
lentigo, the mole (spilus), the several forms of naevus, and the 
liver-spot (ephelis.) 

f Lentigo .... Freckles. 

Macule J Spilus Mole ' 

" | Naevus . . . .Mother's Mark. 

[_ Ephelis. . . .Liver-Spot. 



THEORY AND PRACTICE OF MEDICINE. 47 1 

LENTIGO. 

FRECKLES. 

These are small round discolored spots on the skin of 
young fair complexioned persons with red or auburn hair. 

Treatment. — Ammonium card., graphites, kali carb., 
lycopodium, muriatic acid, nitric acid, nux moschata and 
sulphur, are all laid down as having more or less influence in 
the removal of freckles. It is said that pulverized nitre 
moistened with water, and applied night and morning, has 
removed freckles. 

SPILUS. 

MOLES. 

These are discolored elevations appearing on any part of 
the body. They are sometimes small and few, while in some 
cases they are large. 

Treatment. — Thuja internally, and an application of 
the tincture to the moles will usually remove them. If not, 
then the application recommended for naevus may be tried. 

N/EVUS. 
mother's mark. 
This is a congenital discoloration of the skin, supposed to 
be made upon the child, while in utero, by reflex action of 
the mother's mental faculties. A sudden excitement of grief, 
joy, fright and a sudden shock to the mother by sight of 
something unusual is liable to mark her child. It produces 
various colors, and are said to represent a cherry, strawberry, 
mulberry, tomato, and port-wine stains. The nsevous is some- 
times covered with hair and is called naevus pilaris, and is 
also known as mouse-mark. 

Treatment. — Lycopodium for nsevous maternus. 
Thuja is recommended for nsevous and calcarea carb, also. 
I can not find many remedies that are strictly homoeopathic. 



472 THEORY AND PRACTICE OF MEDICINE. 

Dr. Hempel claims to have cured naevi by the external ap- 
plication of a solution of kre solum, one drop to eighty drops 
of water. He applied this two or three times a day until ex- 
coriation and ulceration took place. Cicatrization afterwards 
took place, leaving the parts smooth and healthy looking. 

I cured a case once by the application of tartar emetic 
ointment. I applied it once a day until the naevus became 
pustular. When they healed the skin was left smooth. 

EPHELIS. 

LIVER-SPOTS. 

Symptoms. — This affection is characterized by a dis- 
coloration of the skin in small patches, which enlarge, They 
are of a grayish or yellowish tinge ; sometimes of a brownish 
hue. They usually appear on the fore-part of the body, but 
may occur on the face. They are caused by slight obstruction 
to the portal system and are amenable to treatment. 

Treatment. — Lycopodium, mercurius cor., podophyl- 
lum, sepia and sulphur are all homoeopathic to liver spots. 

FURUNCULUS. 

BOIL. 

Symptoms. — Boils are various sizes, ranging from a 
small pea to that of a hen's egg. They begin with a hard, 
inflamed, painful swelling; the base is red, but as the disease 
advances it becomes purple. As pus begins to form the swel- 
ling enlarges and becomes throbbing. Boils may occur on 
any part of the body, but more generally appear on the arms, 
neck, back and nates. When boils appear and do not suppu- 
rate, but slowly subside, they are called blind-boils. The dif- 
ference is due to the fact that when a person has boils if he is 
bordering on the hyperplastic diathesis they dry up without 
the formation of pus. If the patient is in the plastic or nor- 
mal diathesis then they suppurate slowly. If in the aplastic 
condition they readily suppurate. 



THEORY AND PRACTICE OF MEDICINE. 473 

Treatment. — Belladonna is the remedy par excellence 

for boils. 

Apis. — This remedy should be used when there is much 
tumefaction and stinging pain. 

Arnica.- — If boils are the result of bruises, then arnica 
should be given first of all. 

Arsenicum. — Is indicated when the pain is of a burning 
nature and the boils are dark, and the patient is prostrated. 

Hepar sulphuris. — When I wish to abort boils I give 30X 
of this remedy, but if there is pus already forming then I 
sprinkle the boil thickly with the ix or 2x trituration of 
hepar sulphur, and apply a flaxseed poultice. 

Nitric acid. — This remedy is indicated for boils when a 
patient is in the aplastic or feeble condition. 

Silicea. — Dr. Madden thinks that this remedy will often 
arrest the progress of boils ; it is also valuable for indolent 
chronic boils. 

Sulplmr. — This agent is said to prevent the return of 
boils. 

Local Treatment. — I feel confident that I have aborted 
boils by applying three times a day, the aconite, belladonna, 
and iodine liniment to which I have already referred. It must, 
however, be applied in the incipient stage to be successful. 

If suppuration can not be prevented then I apply the poul- 
tice and hepar as stated above. When the central slough or 
core is out, then I change to the bread and milk poultice ; it 
is soothing and healing. After the boil no longer discharges 
pus, then it may be dressed with vaseline, containing a few 
drops of carbolic acid. 

MALIGNANT PUSTULES. 

DELHI OR SCINDE BOIL. 

This is a contagious and very fatal disease, common in 
France, where it bears the name charbon ; comparatively rare 
in England and the United States. It begins as a small dark 
red, painful spot, upon which there soon appears a pustule or 



474 THEORY AND PRACTICE OF MEDICINE. 

vesicle, seated on a hard inflamed base. When this is opened, 
a black slough becomes apparent. This sloughing spreads 
rapidly, involving the cellular tissue, and sometimes even the 
adjacent muscles. The disease appears to be caused by infec- 
tion from horned cattle, which are sometimes affected by a 
similar disease, but it arises also by inoculation of diseased 
fluids. It is believed that flies which have alighted on the 
ulcers of diseased animals may occasionally convey the infec- 
tion. The constitutional symptoms are much the same as 
those of putrid typhus fever. 

Treatment.— The first thing to be done is to destroy 
the eschar, by strong tincture of iodine, carbolic acid or nitric 
acid. 

Lachesis. — Malignant pustules, bullae dark from bloody 
serum within. 

Arsenicum. — Black vesicles causing burning pain ; burn- 
ing, stinging pains, as from red-hot needles ; prostration of 
a low typhoid or typhus condition. 

Aurum metallicum. — Small and large blotches, stinging, 
burning, feeling like hard knots. 

ANTHRAX. 

CARBUNCLE. 

Symptoms. — This affection usually appears on the 
neck and back, and is marked by inflammation of a circular 
shape, varying from one to seven inches. The part is hot, 
hard, red and swollen ; the pain is dull, burning and throb- 
bing. After a few days the skin turns purple, or of a brown- 
ish tint, and begins to soften in the center, when several 
whitish openings are observed, thus showing that suppura- 
tion has set in. The suppuration is slow, indeed there is but 
little pus formed ; the tumefaction is lessened by sloughing 
until nearly all of the diseased tissues are consumed. 

Diagnosis. — A boil has but one head or opening, while 
a carbuncle has many ; an d then again a carbuncle is much 
larger than a boil. 



THEORY AND PRACTICE OF MEDICINE. 475 

Prognosis. — During epidemics when the vitality of 
the people are lowered, then if carbuncles prevail, it is often 
a very fatal disease. I have, however, never seen any bad 
results under homoeopathic treatment. 

Treatment. — Aconite must be given if the fever and 
inflammation are of the sthenic grade. 

Apis. — If the swelling is extensive and the inflammation 
has a tendency to spread, accompanied with a stinging pain, 
then apis is our main remedy. 

Arsenicii7n. — When the carbuncle is large and malignant, 
with burning pain, and prostration of the patient, we have 
nothing equal to arseniciun. 

Belladonna. — Is called for when the tissues are bright-red, 
and any headache or tendency to brain complications. 

Lachesis. — Carbuncles, with purple surroundings, and 
many small boils surrounding them ; thus showing a poi- 
soned condition of the blood. 

Silicea. — This remedy has a tendency to arrest sloughing 
and promote healthy granulations. 

Local Treatment. — When I was an allopath, I used to 
make incisions through the carbuncle, but since I became a 
homceopathist I have discarded that operation entirely. When 
the parts look dark and have a burning sensation, I have 
found nothing more soothing than a flaxseed poultice, con- 
taining pulverized charcoal. When the carbuncle begins to 
look pale, I then leave out the charcoal, and sprinkle the 
parts with ix or 2x trituration of hepar sulph., and continue 
the flaxseed poultice. This treatment hastens sloughing of 
the devitalized tissues, which has to take place before granu- 
lation can occur. I have used raw tomatoes to the carbuncle, 
and I have thought that they were more soothing, and pro- 
moted suppuration better than any thing that I have tried. 
When the sloughing becomes extensive, then the parts should 
be cleansed once a day with warm water, containing carbolic 
acid, half a drachm to a quart of the water. The patient 
must be nourished with beef extract, eggs, milk and malted 



476 THEORY AND PRACTICE OF MEDICINE. 

milk, or in other words, his system must be brought into the 
normal diathesis as soon as possible. 



WHITLOW. 

FELON. 

This is sometimes called gathered finger. There are three 
varieties. 1. The cutaneous whitlow, which is characterized 
by inflammation of the outer skin, which raises into a bladder 
filled with a bloody fluid; it is attended with a burning pain. 

2. The subcutaneous is attended with pain and suppuration 
under the skin at the root of the nail, which often comes off. 

3. Tendinous whitlow, or thecal abscess, is an inflammation of 
the tendinous sheath of the finger. They all begin with red- 
ness, heat, pain and swelling, and after a longer or shorter 
time an abscess forms. The thecal abscess is one of the most 
painful affections that we have to contend with. 

Treatment. — Apis for swelling, stinging pain, bella- 
donna for redness and throbbing pain. Some have recom- 
mended carbolic acid 3X as a valuable remedy. Fluoric acid, 
hepar sulphur and mercurius, are all recommended. I have 
applied the tincture of dioscorea y externally, with the view 
of aborting the whitlow ; the pain ceased, but I have not had 
experience enough with the remedy to speak positively as to 
its merits. 

Rhus tox. — Swelling of the fingers, hang nails. 

Silicea. — Some think that the 3X of this remedy will abort 
a whitlow. It is used for bone-felons with deep seated pains, 
burning, stinging, aching, in superficial parts. Run-a-rounds ; 
ulceration about the nails ; hang nails ; finger-tips burn. 

Strammonium. — Pain intolerable, drives to despair. 

I have but little confidence in many external applications 
that are advocated. I think that when a whitlow begins to 
develop it may often be arrested by producing anaesthesia of 
the part by saturating a bit of cotton with chloroform and apply- 
ing to the inflamed part, and cover with paper. Let it remain 



THEORY AND PRACTICE OF MEDICINE. 477 

until pain and sensibility is lost, then expose to the atmos- 
phere, and when tenderness begins to return then apply the 
chloroform again, and continue the same methods until the 
finger is free from pain. After whitlow has progressed so far 
that the pain is almost unbearable, then the inflamed part may 
be touched with strong nitric acid. The sound skin must be 
protected by the use of oil. 

Whenever it is evident that we can not arrest a whitlow, 
then it should be lanced deeply through the periosteum, in 
order to save the bones of the finger. It is unnecessary to 
wait until matter has formed, for the sooner the periosteum is 
laid open the quicker the finger will recover. 

BURSITIS. 

housemaid's knee. 

This is called housemaid's knee, and miner's elbow, because 
the inflamed bursa is produced by girls kneeling on damp 
stone steps or hard floors in the act of scrubbing, also by 
miners bruising their elbows. It is a bunion of the knee and 
elbow, the same as found on the foot from tight shoes. 

Symptoms. — The parts over the joints become thick- 
ened, tender, swollen, painful and feverish. If not arrested 
suppuration may supervene, or the bursa may enlarge and 
form a hard projection. 

Diagnosis. — Bursitis is always found in front of the 
knee, while synovitis surrounds the joint. 

Treatment. — When the irritation is first felt, arnica 
both internally and externally will usually restore the parts. 

Belladonna. — When the parts are red and painful, then 
belladonna will prove beneficial. 

Iodine. — Hot, bright red swelling of the knee, with inflam- 
mation, pricking and burning ; aggravated by touch or pres- 
sure ; painful bunions and corns on feet. 

Ledum. — Ball of great toe painful, swollen ; soles very 
sensitive, tendons stiff. 



47$ THEORY AND PRACTICE OF MEDICINE. 

With the foregoing treatment, and the external use of the 
iodine liniment containing aconite and belladonna, as hereto- 
fore mentioned, I have never failed to remove bunions of the 
knee, elbow and foot. When the bursa becomes hard and of 
long continuance it may take several months to remove them 
entirely. 

TUMOR SEBACEUS. 

WEN. 

These tumors appear under the skin and are movable ; 
they are free from pain, and often attain a large size. 

Treatment. — Baryta carb., calcarea, iodide of potash, 
lycopodium, silicea, and sulphur, are recommended for their re- 
moval. But where they are stubborn I have removed them 
by the iodine liniment. 



VERRUC/E. 

WARTS. 

It is unnecessary to go into a dissertation on warts, for 
every one knows them at sight. They are an excrescence on 
the skin, producing a smooth, hard surface, or of a craggy ap- 
pearance, called seedy warts. 

Treatment. — Thuja internally and externally will usu- 
ally eradicate warts. If followed by sulphur for a few weeks, 
it is said that they will not return. One writer claims that 
dulcamara 3X has cured many cases. Antimonium crudum 
is also said to be a good remedy. 

POISON OF INSECTS. 

The poison from the sting of the bee, bumblebee, cente- 
pede, hornet, gnat, mosquito, wasp, yellow-jacket, etc., cause 
an irritation, swelling and pain. Some persons have been 
stung to death by a swarm of bees. 



THEORY AND PRACTICE OF MEDICINE. 479 

Treatment. — Some of the insects I have mentioned, 
often sting so deeply as to leave their sting in the flesh. 
When that is the case the sting must be extracted with sharp- 
pointed forceps. 

Ledum palnsti r e is a valuable remedy. It should be given 
internally, and applied to the part with a piece of cotton 
saturated with a solution of the tincture, say thirty drops to 
an ounce of water. I have found that the application of the 
tincture of 'iodine often destroys the poison and greatly relieves 
the patient. Iodine is an antidote to the poison of insects 
and serpents. Dr. Hill says that allium cepa — onion — cut in 
thin slices and applied to the parts and changed often, has cured 
many cases in his hands. If there is fever and much swell- 
ing aconite and apis may be called for. 

SERPENT'S BITE. 

The rattlesnake, copperhead, moccasin and scorpion, are 
the most venomous of the reptiles of America ; their poison 
often destroys life in a few hours. 

Treatment. — The poison must be antidoted in order 
to save the patient. If the patient survives the worst symp- 
toms, then arsenicum is a valuable remedy for the typhoid 
condition that may be developed. Many recommend large 
quantities of whisky, others use hypordermic injections of am- 
monia. But from my experience I think that there is noth- 
ing equal to iodine as an antidote to the poison of serpents. 

Many years ago Professor Daniel Brainard experimented 
largely on guinea pigs, rabbits, and birds, and found that 
by injecting iodine solutions before the bite, that the sub- 
jects felt no bad results, in others he gave no treatment 
after the bite, and the animal died in a short time, while others 
that were bitten and were immediately injected, the poison 
had little or no effect. He used a solution of iodine, ten 
grains, iodide of potash, thirty grains, and pure water one 
ounce. In case that man should be bitten by venomous 



480 THEORY AND PRACTICE OF MEDICINE. 

serpents, then the first thing to be done is to suck the wound, 
apply a cupping glass over the bite, and inject one drachm of 
the foregoing iodine solution into the tissues under the glass, 
and repeat as often as is necessary, and continue until the 
patient is better. If the patient is relieved, and there are 
any symptoms of iodism produced then a strong solution of 
starch given internally will produce iodide of starch, which is 
harmless. The poison of some serpents is so virulent that it 
kills in a few hours. In that case poisonous symptoms of 
iodine should be developed as rapidly as possible, for a solu- 
tion of starch will certainly antidote the iodine after it has 
neutralized the serpent's poison. 

If a bystander has no sore in his mouth, and no decayed 
teeth, then it is supposed that he can suck the poison from the 
bite with impunity by washing his mouth afterwards. I 
should recommend that he wash his mouth with a weak solu- 
tion of iodine to make sure. 



BURNS AND SCALDS. 

These conditions are produced by the application of fire, 
hot liquids, steam, hot bodies and gaseous substances. We 
have three conditions. 1. Erythematous, simple redness of 
the skin. 2. Vesiculated, in which the cuticle is so affected 
as to lead to an exudation of serum, and the formation of 
vesicles. 3. Gangrenous, a destruction of the tissues. Burns 
on the body, head or neck, are much more dangerous than 
the same character of burns on the extremities. There are 
three stages of constitutional disturbances following deep 
burns. 1. Congestion and depression during the first few 
days. 2. Reaction and inflammation of some of the internal 
organs. 3. Exhaustion following suppuration which may last 
for weeks. 

Treatment. — I will not repeat the long list of exter- 
nal treatment recommended by different authors, but will say 
that after trying them all, they have been discarded and only 



THEORY AND PRACTICE OF MEDICINE. 48 1 

give what I have found to be most satisfactory after an ex- 
perience in many cases during the last thirty-seven years. I 
will say, however, that I have found that an application of 
bicarbonate of soda to be very soothing, but as we will have to 
adopt another dressing after the pain subsides, I have rejected 
the soda also. 

In the treatment of the erythematous variety, I have 
found a solution of cantharides, ten drops to a goblet of water, 
to be very soothing. Absorbing cotton should be saturated 
with the solution and applied to the inflamed parts ; it should 
be kept wet and not removed until inflammation has passed. 
Twenty to thirty drops of the tincture of urtica urens to a 
goblet of water and applied in the same way is also a val- 
uable application. 

The vesicular variety may be treated in the same manner 
after picking the blisters with a needle without breaking the 
cuticle. The dressing should not be removed until the parts 
are healed unless there should be some discharge. I think, 
however, if the blisters are very extensive, it is best to treat 
the vesicular and the gangrenous varieties alike in the begin- 
ning ; that is, as a rule, all extensive burns require a stimu- 
lating application. I have found nothing more beneficial 
than an ointment composed of two ounces of resin ointment 
and half an ounce of oil of turpentine. Mix well and spread on 
linen cloths and apply to the burnt surface, cover the part 
with a thin layer of lint. This dressing should not be re- 
moved for several days, or until the parts begin to discharge, 
then the parts should be washed in a solution of calendula or 
carbolic acid, and afterwards dressed with the chalk ointment. 

This is a compound of prepared chalk two ounces, lard 
half an ounce, and olive oil halt an ounce, or a sufficient quan- 
tity to make a soft smooth ointment. It should be spread on 
linen cloths, and applied to the raw surface. This also should 
remain several days unless there is much discharge. In the 
majority of cases I use no other application, and continue it 
until the new skin has formed. By this plan I have never 



482 THEORY AND PRACTICE OF MEDICINE. 

seen any scars left after the parts were healed unless the tis- 
sues were destroyed deeply. In that case, if the parts begin to 
slough and discharge an offensive sanies, then we must adopt 
the same plan of treatment as recommended for gangrene in 
erysipelas. 

Internal Treatment. — Aconite. — This should be given 
if fever follows reaction. 

Arnica. — To allay extreme sensibility, general restlessness 
and intense pain, at the seat of injury. 

Arsenicum. — If ulcers form and gangrene threatens. 

Carbo veg. — In those extreme cases where the shock is so 
excessive as to threaten complete extinction of life. 

Causticum. — For old burns, burns of the lips and tongue. 

Coffea. — To promote sleep and allay nervous excitement. 

Phosphoric acid. — When there is hot skin, thirst, hard and 
frequent pulse. 

If the patient should require stimulants, strong coffee, beef 
extract, and unfermented-grape juice, are essentially organic 
stimulants, milk, soft eggs, and malted milk must be given 
for nourishment. 



CONTUSION. 

BRUISE. 

This is caused by a blow or falls. If the bruise is slight 
it produces a red discoloration of the skin, which turns black 
after a few hours, and is called ecchymosis. But when a 
bruise involves the deeper tissues, then it sometimes becomes 
serious. 

Treatment. — Arnica internally, and a warm arnica 
lotion, half an ounce to a quart of warm water, should be ap- 
plied by saturating cloths in the solution, and repeat as often 
as they become dry. The parts must be kept warm. 

If the glands are involved in a bruise, such as the female 
breast, then conium, both internally and externally, should 



THEORY AND PRACTICE OF MEDICINE. 483 

be used. If erysipelatous symptoms should develop in a 
bruise, then the treatment recommended for that disease must 
be adopted. 

SPRAIN. 

STRAIN. 

This is an over-stretching of the ligaments and tendons, 
with rupture of some of their fibers. 

Treatment. — Rest is of the highest importance. When 
possible the limb should be bandaged, and a warm solution 
of rhus tox., ruta or Hypericum should be applied until pain 
abates ; then the limb should be tightly strapped to prevent 
movement of the joint. 

Rhus tox. — This remedy is always indicated for sprains. 

Hypericum. — Is valuable when the fingers and toes are 
involved, and when the nervous fibers have been injured. If 
there is fever, heat and redness of the part, aconite may be 
called for. If the patient is bruised as well as strained, then 
arnica should be given. 

GANGLION. 

This consists of small movable tumors on back of the 
wrist of one or both hands; they are generally free from pain. 

Treatment. — I have been able to remove those cysts 
by the application of the iodine, aconite and belladonna lini- 
ment, to which I have already referred. 

It is said that the internal and external use of benzoic acid 
has cured. Phytolacca and mezereum are also recommended. 



484 THEORY AND PRACTICE OF MEDICINE. 



DISEASES OF THE EYE. 

These affections are thus classified. 

r Conjunctivitis. .Inflammation of the Conjunctiva, 

Sclerotitis Inflammation of the Sclerotica. 

Corneitis Inflammation of the Cornea. 

<^ Iritis Inflammation of the Iris. 

Choroiditis .... Inflammation of the Choroid. 

Retinitis Inflammation of the Retina. 

Gutta Serena . .Amaurosis. 



Diseases of 
the Eye 



The following table shows the diseases of the conjunctiva. 
("Catarrhal Ophthalmia. 
Conjunctiva. <> Purulent Ophthalmia j°[ ™^*' 

L Strumous Ophthalmia. Scrofulous Ophthalmia. 



CATARRHAL OPHTHALMIA. 

Some authors speak of simple conjunctivitis, but as it is 
only a milder type of catarrhal conjunctivitis, I include them 
both under one head. 

Symptoms. — One or both eyes may have a slight burn- 
ing pain, with itching and redness of the conjunctiva. There 
is often a feeling as if sand was in the eye. There is intoler- 
ance of light, the redness begins on the edge of the lids and 
extends towards the cornea ; if it spreads over the cornea the 
vision is obscured. There is often considerable flow of tears, 
and a mucous secretion. 

Treatment. — In all diseases of the eye we must diag- 
nose our remedies closely. 

Aconite. — This is generally indicated for catarrhal oph- 
thalmia in the early stages. 



THEORY AND PRACTICE OF MEDICINE. 485 

Arsenicum. — The conjunctiva looks like a piece of raw beef. 
The first case I was called to see after I became a homceopathist 
I thought that I saw the picture of belladonna. After giving it 
for two days with no improvement, the patient said that she 
was thirsty, but the water tasted badly, and she could only 
take a sip at a time. I then had the key-note, and gave her 
arsenicum, and in less than twenty-four hours she was relieved. 

Belladonna. — Bright sparks before the eyes ; conjunctiva 
covered with red vesicles ; eyes feel dry as if sand was in them. 

Euphrasia. — Inflammation with intolerance of light and 
copious lachrymation. 

PURULENT OPHTHALHIA. 

CONTAGIOUS OPHTHALMIA. 

This is called Egyptian ophthalmia of adults because it is 
supposed that it had its origin in Egypt, and was conveyed to 
other portions of the world. It begins with intense inflamma- 
tion of the conjunctiva, generally affecting both eyes, accom- 
panied by a profuse purulent discharge. The lids and ante- 
rior surface of the eye are swollen and granular, and the cornea 
is sunk, as it were, into a deep pit formed by the projection of 
the conjunctiva. 

Prognosis. — Very unfavorable; the tendency to the 
deeper structures and ulceration and rupture of the cornea 
renders our prognosis grave. 

Causes. — Contagion, and the crowding of persons in 
filthy localities. 

Treatment. — Aconite. — This is indicated for the in- 
flammatory stage. 

Argentum nitricum. — This is the remedy, par excellence^ 
for inflammation of the eye, with purulent discharge. 

Arsenicum. — Eye-ball feels like a globe of fire ; acrid se- 
cretion, burning, stinging pains. 

Mercurms. — Copious discharge of mucus and pus ; agglu- 
tination of the lids. 



486 THEORY AND PRACTICE OF MEDICINE. 

Mercurius cor. — Violent forms with extreme dread of 
light, or in chemosis, where the conjunctiva is elevated above 
the transparent cornea. 

Zincum. — Conjunctivitis, pains ; worse at night ; inflam- 
mation more in inner canthus. 



OPHTHALMIA NEONATORUM. 

PURULENT OPHTHALMIA OF INFANTS. 

This is an inflammation of the conjunctiva, involving the 
whole mucous membrane of the eye. It occurs in children 
about the second or third day after birth. 

Symptoms. — The child is fretful, and the eye looks 
red as though it had taken cold. The conjunctiva begins to 
swell, and has a darkish appearance ; the lids become so 
much swollen that the lids often can not be opened, and the 
conjunctiva overlaps the cornea, and protrudes between the 
swollen lids. There is a copious discharge of a yellowish or 
greenish purulent substance from the eye. In trying to open 
the eyes, I have seen the purulent discharge pouring out like 
as from a small abscess. 

If the disease is not arrested at this stage, opacity of the 
cornea will soon develop, with probable ulceration and pro- 
trusion of the iris, followed by total blindness. But thanks 
to Samuel Hahnemann and his law of cure, such a result is 
now rare under homceopathie treatment, if the child is seen 
in time. 

Prognosis. — Favorable if seen early and treated prop- 
erly ; if not it is very grave. 

Diagnosis. — The severity of the case distinguishes this 
disease from simple sore eyes from cold. 

Causes. — Due to an acrid condition of the liquor amni 
or the secretions of the vagina. 

Treatment. — This is a case in which homoeopathy can 
demonstrate its superiority over all other plans of treatment. 



THEORY AND PRACTICE OF MEDICINE. 487 

I will mention a few remedies that I have found homoeo- 
pathic. 

Aconite. — Early stage ; child feverish and restless. 

Apis. — This is an excellent remedy for the swelling of the 
lids and conjunctiva. 

Argentum nitricum. — This remedy is almost specific in puru- 
lent ophthalmia of children. I have seen cases recover when 
there seemed to be scarcely a hope of saving the eyes. It 
should be administered as soon as the discharge becomes puru- 
lent, or sooner if the other apparently indicated remedies fail 
to relieve. I well remember the solicitude I once had for the 
worst case I ever saw. In attempting to separate the lids a 
purulent secretion boiled out as though there was a powerful 
force behind it. I at once took in the gravity of the situation 
and administered argentum nitricum internally, and with a 
small syringe I cleansed the eyes from pus by injecting warm 
water containing a few drops of tincture of calendula. This 
was repeated twice a day or as often as was necessary to re- 
move the pus, for the danger to the cornea is enhanced by the 
purulent matter remaining in contact with it. 

When I cleansed my little patient's eyes from the purulent 
matter, I dropped one drop of a solution of argentum nitricum, 
two grains of the crystals to an ounce of water, into the eyes 
once a day until the pus ceased to accumulate. I was then 
able to examine the cornea and found some degree of opacity 
and ulceration, aud as the argentum nitricum had arrested the 
progress of the disease, and the conjunctiva began to assume 
a more natural appearance, and as the ulcers and opacity 
seemed to remain at a stand still, I put the patient on mercu- 
rius cor., to arrest the further ulceration of the cornea. Upon 
a further examination I found that I had another foe to con- 
tend with, the eyes were painful, and other evidences of the 
deeper structures becoming involved. To allay pain and pre- 
vent adhesions of the iris, I put one drop of a solution of sul- 
phate of atropia, two grains to an ounce of distilled water, 
into each eye once a day or till the pupils were dilated. They 



THEORY AND PRACTICE OF MEDICINE. 

were then allowed to contract, and if pain had not subsided, 
or still danger of adhesions, the solution of atropia was con- 
tinued as before. The ulcers finally healed, and only inden- 
tations of the cornea were observed, and finally they disap- 
peared, and the eyes and sight were perfect. 

Arsenicum is sometimes indicated for ulceration of the 
cornea, if the mercurhts cor. does not act promptly. 

Sulphur is a good remedy for convalesence to prevent 
relapses. 

STRUriOUS OPHTHALniA. 

This disease only attacks persons of a scrofulous diathesis, 
producing phlyctsena — blisters — and pustules. 

Symptoms. — Children from two to nine or fifteen 
years of age are the subjects of this disease. There is a 
slight partial redness of one or both eyes, sometimes confined 
to the eye-lids, and in the form of groups of enlarged vessels 
running from the circumference of the eyes to the edge of the 
cornea, where they terminate in small pustules, which break, 
and form minute ulcers. Sometimes the injection extends to 
the conjunctival covering of the cornea, and pustules are 
formed upon its surface. There is intolerance of light, the 
eye-brows are contracted, and the nostrils and upper lip drawn 
upward. There is a profuse flow of scalding tears whenever 
the eye is exposed to light, which flowing over the skin, ir- 
ritate and inflame it, and sometimes give rise to a pustular 
eruption, accompanied by white scabs. 

Prognosis. — If the strumous diathesis is strongly 
marked, then our prognosis as to cure must be guarded. If 
it is slight, then we can promise a cure. 

Treatment. — The diet and sanitary surroundings must 
be the same as that for scrofula. Fortunately many homoeo- 
pathic remedies that* are indicated for the -conditions of the 
eyes, are also beneficial for the removal of the scrofulous 
diathesis. ' 



THEORY AND PRACTICE OF MEDICINE. 489 

Arsenicum. — Inflammatory swelling of the lids ; specks 
or ulcers on the cornea ; nightly agglutination of the lids. 

Calcarea carb. — Scrofulous ophthalmia ; swelling and 
redness of the eye-lids, with nightly agglutination ; stinging 
pains, w r orse from candle light. Specks and ulcers on the 
cornea ; can not bear the light ; glandular swellings of the 
neck, and eruptions on the hairy scalp. 

Euphrasia. — Vesicles, or specks and ulcers on the cornea ; 
copious secretion of mucus and tears ; swelling of the eye- 
balls ; fluent coryza and headache ; photophobia, flickering of 
the light. 

Graphites. — Ulcers on the cornea ; eyelids much inflamed 
and painful ; constant desire to keep the eyes covered ; un- 
healthy skin, with eruptions oozing out a sticky glutinous 
fluid. 

Mercurius. — Scrofulous ophthalmia ; cutting, burning 
pains, or pressure in the eyes as if from sand ; pustules and 
scurfs around the eyes and on the margins of the lids. 

Spigelia Vessels of the conjunctiva much congested ; 

upper lids swollen and stiff ; aching pains deep in the orbits 
when touched. 

Sulphur. — Scrofulous ophthalmia ; itching, burning in the 
eyes and eye-lids, worse by moving or exposing them to light ; 
feeling as if sand were in the eyes ; specks and ulcers on the 
cornea ; flashes of heat, and weak spells ; burning on top of 
the head. 

SCLEROTITIS. 

INFLAMMATION OF THE SCLEROTICA. 

The sclerotic and cornea form the external tunic of the 
eye-ball, and give to it its peculiar form. It is the white por- 
tion of the eye-ball. Four-fifths of the globe are invested by 
the sclerotic, the remaining fifth by the cornea. This disease 
is sometimes called rheumatic ophthalmia. 

Symptoms. — The globe of the eye is of a bright red- 
ness, especially around the cornea, where the straight vesicles 



490 THEORY AND PRACTICE OF MEDICINE. 

of the sclerotic are seen arranged as radii extending a short 
distance over the margin of the cornea, and there abruptly ter- 
minating. There is intolerance of light, and a great flow of 
tears. There is intense pain at times, the patient suffering 
most towards evening, and reaches its acme by midnight, when 
the pain abates towards morning. The vision is somewhat 
impaired owing to a haziness of the cornea. 

Diagnosis. — Conjunctivitis has superficial redness and 
flow of mucus, while sclerotitis has deep redness and pain with 
a great flow of tears. 

The prognosis is favorable if treated promptly. 
Treatment. — Belladonna. — Vivid redness of the scle- 
rotica, with discharge of hot, salt tears, or great dryness of 
the eyes ; sharp pains in the orbits, extending to the brain ; 
stinging pains, worse from candle-light. 

Aurum metallicum. — Red sclerotica, burning, stitching 
drawing and itching at the inner canthus. 

Arsenicum. — Yellowness of the sclerotica. 

Colchieum. — Violent, sharp tearing pain in and around 
the eye-ball ; drawing digging pain, deep in the orbit, like in 
sclerotitis. 

Euphrasia. — Aching pain in the eyes and redness of the 
sclerotica ; copious flow of tears ; fluent coryza and headache ; 
photophobia. 

Spigelia. — Rheumatic and arthritic ophthalmia; aching 
pains deep in the orbits when touched. 

Sulphur. — Specks and ulcers on the cornea ; this is a valu- 
able remedy, as it were, to cleanse the system and hasten the 
cure where the disease seems tardy about yielding. 

CORNITIS. 

INFLAMMATION OF THE CORNEA. • 

Symptoms. — The cornea has at first a hazed appear- 
ance which finally ends in opacity and ulceration. The ves- 
sels of the conjunctiva and sclerotic become injected. The 



THEORY AND PRACTICE OF MEDICINE. 49 1 

cornea sometimes has the appearance of a cloth, or pannus, 
spread over it, due to the fact that its mucus covering is 
loosened and thickened. I have seen one case in which a de- 
posit of lymph appeared between the layers of the cornea, 
and gave the appearance of ivory, and nearly obscured the 
sight. As a rule this disease is free from the acute suffering 
observed in other diseases of the eye. 

Diagnosis. — It is of a slow chronic nature, and free 
from those severe attacks of other diseases of that organ. 

Prognosis. — Unfavorable in scrofulous, syphilitic, and 
broken-down constitutions. But under homoeopathic treat- 
ment many diseases of the eye heretofore considered incurable 
are often amenable to treatment. 

Symptoms. — The first thing to be done is to change 
the patient's mode of diet and surroundings. All forms of 
pork and lard should be avoided ; milk, soft-boiled eggs, 
malted milk, fresh meat of all kinds, except pork, should be 
allowed. 

Arsenicum. — Specks or ulcers on the cornea, unhealthy 
skin and debility. 

Calcarea carb. — Specks and ulcers on the cornea, scrofu- 
lous diathesis, glandular swelling, and want of assimilation. 

Graphites. — Ulcers on the cornea, unhealthy skin, with 
oozing eruptions. 

Mercurius cor. — Deep ulcers nearly covering the cornea. 
I once cured a case with this remedy when the cornea was 
nearly covered with a deposit of lymph resembling ivory. 
He recovered his sight entirely, and the cornea was perfect. 

Silicea. — Opaque cornea ; spots and cicatrices on cornea ; 
corneal fistula. 

Sulphur. — Speck and ulcers on cornea ; scrofulous di- 
athesis. 



492 THEORY AND PRACTICE OF MEDICINE. 

IRITIS. 

INFLAMMATION OF THE IRIS. 

This affection may be either acute or chronic. The iris 
is a movable curtain, having a circular aperture nearly in its 
center, and occupies the space between the cornea and crystal- 
line lens. Its function is the regulation of the proper amount 
of light to the eye by its power of contraction and dilatation. 

Symptoms, — A red zone arranged as radii around 
the circumference of the cornea, and terminating abruptly 
near its edge, the redness after a time extending to the con- 
junctiva, are the first symptoms pointing to iritis. The iris 
soon looses its brilliancy and color, and becomes muddy ; 
lymph is either effused into its substance, thrown out from 
its edge, or deposited upon its anterior or posterior surface, 
the whole chamber of the eye is often filled with it. The 
pupil contracts, and becomes irregular in shape, from effusion 
into its substance and adhesions to surrounding parts. The 
sight becomes dim, and often vision is entirely lost. The 
pains are often severe in the eye, darting to the cheek and 
temple, worse at night. 

Prognosis. — Very grave unless seen early and yields 
readily to treatment. 

Causes. — Rheumatic, gouty, scrofulous and syphilitic 
diathesis. The exciting causes are over-use of eyes, surgical 
operations, and mechanical injuries. 

Treatment. — If there are febrile symptoms aconite 
should be given at first. 

Arnica. — This remedy should be given both internally, 
and used externally after all operations or blows on the eye. 

Belladonna. — Sharp pains in the orbits, extending to the 
brain. 

Clematis erecta. — Inflammation of the iris, complains from 
bright light. 

Euphrasia. — Rheumatic inflammation of the eyes. 



THEORY AND PRACTICE OF MEDICINE. 493 

Kali bichromicum. — Rheumatic iritis, pains, pricking, 
stinging, wandering. 

Rhus tox. — Iritis in rheumatic or gouty subjects, with 
suppurative tendencies. 

Mercurius. — Iritis, syphilitic ; pains around the eye, on 
forehead and temple ; throbbing, shooting pains in the eye. 

The iris must be kept dilating and contracting until all 
danger of adhesion is past. 



CHOROIDITIS. 

INFLAMMATION OF THE CHOROID. 

Symptoms. — The symptoms of this disease are so 
blended with the other membranes of the eye that it is some- 
times difficult to distinguish except by the blue zone around 
the cornea, followed by the protrusion of small dark-blue 
tumors. The pupil is displaced or contracted, with a narrow- 
ing of the iris, and opacity of the cornea. The pain and in- 
tolerance of light are almost unbearable. Dimness of sight, 
and total blindness often supervene on account of the pressure 
on the retina. The globe of the eye often becomes enlarged, 
due to an effusion of a serous fluid between the choroid and 
retina. 

Diagnosis. — The blue zone around the cornea and 
bluish protrusions through the sclerotica. 

Treatment. — This must be upon general principles in 
accordance with pain and photophobia. If the eyes are pain- 
ful and feverish then aconite is a good remedy. 

Belladonna, — Vision obscured as from a white vapor ; 
deep-seated dull pain in back of the eye. 

Rhus tox. — Of rheumatic origin, and where the ciliary 
body and choroid are involved. 

Spigelia. — Eye-balls feel too large ; bluish rings around 
the cornea, iris discolored. 



494 THEORY AND PRACTICE OF MEDICINE. 

RETINITIS. 

INFLAMMATION OF THE RETINA. 

The retina is the inner coat of the eye, containing the sen- 
sory nerve-endings which receive the impressions resulting in 
the sense of vision. Retinitis may be acute and chronic. 

Symptoms. — The pain in the globe of the eye is often 
intense, with headache, intolerance of light, dimness or loss 
of vision, the pupils are contracted and motionless, shining 
spectra of various forms appear. Delirium is often present. 
The chronic variety is only a milder type of the acute. 

Prognosis. — If seen in time, and treated promptly, the 
prognosis is generally favorable, but it must be guarded when 
the whole eye becomes involved. 

Treatment. — Belladonna. — Deep-seated dull pain in 
±he back of the eye. Bright sparks before the eyes, objects 
appear double, and seem to revolve and run backwards, in- 
verted. Halo around the light parti-colored, red predomi- 
nating- ; at times light seems broken into ravs. Headache 
and delirium. 

Merciirius cor. — Retinitis albuminurica. 

Spigelia. — Photophobia ; over-sensitive retina ; asthenopia 
(accommodative), slight retonitis ; neuralgia ; or with anaemia 
of the optic nerve ; sharp stabbing pains through ball back 
into head, worse from moving; the eves and at night. 

Nnx voinica. — Sight blurred by overheating ; vision im- 
paired by dissipation ; hyperesthesia of the retina ; pains to 
tne top of the head. 

Sulphur. — Retinitis, caused bv over-use of eyes, conges- 
tion of optic nerve ; obscuration of sight ; like a gauze before 
eyes ; halo around gas or lamp-light. 

GUTTA SERENA. 

AMAUROSIS. 

This is sometimes called nervous blindness. 
Symptoms. — A blindness or obscurity of vision caused 
by disease of the optic nerve, and this cause may be situated 



THEORY AND PRACTICE OF MEDICINE. 495 

either at the origin of the nerve in the brain, in some part 
of its course, or at its termination in the retina ; and of course 
the degree of blindness will be in proportion to the extent 
these parts are involved. The patient's movements are un- 
certain ; the expression of countenance vacant ; the eye-balls 
either fixed or oscillating ; his gaze fixed on vacancy, the 
pupil generally dilated and insensible to light. 

Diagnosis. — The pupil is clear and transparent, while 
in other diseases of the eye this is not the case. The ophthal- 
moscope is a valuable aid in diagnosis ; for the condition of 
the optic nerve gives evidence as to the gravity of the case. 
It is also valuable in prognosis, for a hope of cure depends 
upon the condition of the optic nerve. 

Treatment. — Arnica. — This is a valuable agent for 
over-use of the eyes, with dimness of sight. 

Arsenicum. — Everything appears green, sees as through a 
white gauze and weakness of sight. 

Aurum metallicum. — Sees objects as if divided hori- 
zontally ; sees only half of an object, other half as if covered 
with a dark body. Tension in the eyes ; sees things double 
or mixed up ; fiery sparks before the eyes ; optical illusion in 
bright colors. 

Belladonna. — Objects appear double, and seem to revolve 
and run backwards, inverted ; bright sparks before the eyes ; 
flashes of light before the eyes. Halo around the light, parti- 
colored, red predominating ; at times light seems broken into 
rays. 

China or cinchona. — Nocturnal blindness ; worse from 
light ; better in the dark. Scintillations or black motes be- 
fore eyes ; letters pale, surrounded by white borders. 

Cimicifuga. — Dark spots before the eyes, dilated pupils, 
double vision ; intense pains in the eye-balls, worse from 
moving the head or eyes. 

Crocus sativ a. — The light seems dimmer than usual, as if 
obscured by a veil ; appearance of a spot jumping up and 
down before the sight. 



496 THEORY AND PRACTICE OF MEDICINE. 

Euphrasia. — Excessive lachrymation ; also when the com- 
plaint is traceable to catarrh. 

Gelsemium. — Amaurosis of congestive origin ; after apo- 
plexy ; sees double, when inclining the head towards the 
shoulder ; confused vision, eyes heavy ; astigmatism, a defect 
in eye-sight, attended with dimness of vision, arising, it is be- 
lieved, from a structural error or accidental malformation of 
the lens of the eye ; if, in such cases, a luminous point be 
viewed by the eye, it will not appear like a point, but will 
put on some other appearance dependent on the nature of the 
error or malformation. When this trouble is detected early 
homoeopathic remedies will often relieve the patient without 
the annoyance of glasses. Here the homoeopathic ophthal- 
mologist has the advantage over his brother in the old school. 

Glonoinum. — Flashes of lightning, sparks before eyes ; 
objects dance with every pulsation ; dim sight with vertigo, 
with fainting, black spots before eyes. 

Lithium carbonicum. — Black motes before eyes ; sensitive 
eyes after using them by .candle or gas light ; vision uncertain ; 
right half of objects invisible, pain over the eyes ; sunlight 
blinds. 

Nux moschata. — Objects look larger, very distant ; or 
vanish ; red ; motes before the eyes ; worse from light, from 
exerting vision ; better in the dark ; blindness, then fainting. 

Opium. — This remedy is strictly homoeopathic to hyperses- 
thesia or an exalted irritability of the nervous centers ; there 
is obscuration of vision, amblyopia or an incomplete or inci- 
pient amaurosis ; or weakness of sight ; 30X, or higher. 

Phosphorus. — Letters look red when reading ; momentary 
blindness, as from fainting. Amblyopia from loss of fluids ; 
also morbus brightii, paroxysms of nyctalopia; or, a sensation 
as if things were covered with a veil. 

Nyctalopia means night-eye, or day-blindness, called owl- 
sight. There are two opposite conditions of vision described 
by Dr. Forbes. Nyctalopia, vision lost or obscure by day, 
comparatively good at night — night-sight, day-blindness. 



THEORY AND PRACTICE OF MEDICINE. 497 

Hemeralopia. — Vision lost or obscure by night, good or 
comparatively good by day — day-sight, night-blindness, hen- 
blindness. 

Phosphoricum acidnm. — Sees colors, as of the rainbow ; 
blindness, with frequent desire to wink ; torpid amaurosis, 
caused by debilitating losses ; eyes look glassy, lusterless ; 
also with staring. 

Ruta graveolens. — Green halo around light in evening. 

Santoniiinm. — Hyperaesthesia of the retina, then the sight 
becomes suddenly dim. Amblyopia ; retinal anaemia ; after 
eating, the eye-sight becomes suddenly dim ; rubbing clears 
the eye for a few moments. After diphtheria, flashes of light. 

Veratrum album. — Vision obscure by night, comparatively 
good by day. 

Veratrum viride. — Dimness of vision, with dilated pupils ; 
green circles around the candle, which turn to red. 

Zincum. — Amaurosis ; during severe headache, eyes dim, 
watery ; brain affections ; sees luminous bodies. 

MUC42 VOLITANTES. 

This means a floating of black motes, or thin gray films 
resembling flies, before the vision. They are supposed to be 
debris of cells, floating in the vitreous humor. 

Causes. — It may sometimes be the forerunner of am- 
aurosis or cataract. But usually it is due to over-use of the 
eyes, artificial light, badly ventilated rooms, and some forms 
of fever. 

Treatment. — Agaricus muscarius. — Indistinct sight ; 
focal distance changes while reading ; first grows shorter, then 
longer. Dim sight ; things look obscure ; muscae volitantes ; 
vibrating spectra, with vertigo ; reads with difficulty, type 
seem to move. Diplopia, that is the patient sees an object 
double or triple ; black spot before left eye. 

Carbo veg. — Black spots float before the eyes ; must make 
exertion to distinguish letters when reading. 

32 



498 THEORY AND PRACTICE OK MEDICINE. 

China. — Scintillation, or black motes before eyes. 

Cocculus. — Dark spots before the eyes, though objects ap- 
pear clearly. 

Conium macnlatum. — Objects look red ; rainbow-colored ; 
striped, confused spots. 

Digitalis purpurea. — Diplopia ; objects appear either green 
or yellow. 

Kali carbonicum. — While reading or looking at a bright 
light, muscae volitantes ; sharp stitches ; fog before the eyes ; 
bright sparks, blue or green spots before the eyes. 

Silicea. — Black spots before eyes ; a persistent speck before 
right eye. 

CATARACT. 

This is an opacity of the crystalline lens, and produces 
dimness of sight, and if not relieved leads to total blindness. 
There are two varieties, the hard and the soft. 

Treatment. — I have cured two cases of senil cataract 
with sa7iguinaria and silicea. One case the patient could 
not distinguish one letter from another. After six to eight 
months she could see to sew by gas-light. 

Colchicum. — Inflammation of the eyes, dim sightedness ; 
soft cataract. 

Conium maculatum. — Sluggish adaptation of the eye to 
varied range of vision ; cataract from contusion. 

Sanguinaria. — Diminished power of vision, cataract. 

Silicea. — Dim vision ; cataract. 

Sulphur. — Obscuration of sight ; like a gauze before eyes ; 
cataract. 

When cataract is hard and of long standing, medicines will 
have no effect, and the knife must be used to restore sight. I 
think, however, that a course of treatment before an operation 
will greatly enhance the probabilities of success. 

Dr. D. D. Hurd claims to have cured a case af cataract of 
both eyes with the juice of cineraria maritima. I know of 



THEORY AND PRACTICE OF MEDICINE. 499 

no proving of the drug, but if it proves to be curative for 
such a grave trouble as cataract without the use of the knife, 
then we should use it. 



GLAUCOMA. 

This is an opacity of the vitreous humor, characterized by 
a bluish tint seen from without, and the absence of the pecu- 
liar characters of cataract, which, in some respects, it resem- 
bles as regards the gradual obscuration of vision. As the dis- 
ease advances the vitreous humour is increased, halos of vari- 
ous colors around the candle or gas-light, the globe hardens, 
sight grows dim, and often neuralgia and inflammation sup- 
ervene. 

Treatment. — Aconite is indicated for inflammation and 
a feverish condition of the eye. 

Arsenicum. — Gray spots and serpent-like bodies moving 
before the vision ; letters become blurred ; run together ; van- 
ishing of sight. 

Belladonna. — Vision obscured as from a white vapor; 
pupils dilated ; deep seated dull pain in back of the eye. 

Bryonia. — Bye-balls so painful that the patient can not 
bear to have them touched. 

Iodium. — Optical illusions in bright colors ; obscuration of 
sight, like a vail before the eyes 

Ipecac. — Worse from light, especially of a candle. Blue 
and red halo around the light. Obscuration of sight ; eyes 
inflamed, red. 

Phosphorus. — Letters look red when reading ; momen- 
tary blindness ; glaucoma. 

Phosphoricum acidum. — Sees colors as a rainbow ; blind- 
ness, with frequent desire to wink. 

Santoninum. — Idiopathic glaucoma, same indications as 
given under amaurosis. 



500 THEORY AND PRACTICE OF MEDICINE. 

STRABISHUS. 

SQUINTING. 

This is a condition in which the axis of one eye is not 
parallel with that of the other. This is commonly called 
cross-eyed. When the squint is towards the mesial line, it is 
called convergent ; if outwards, divergent ; if confined to one 
eye, monocular ; if the squint alternate between the two eyes, 
it is called binocular. 

Treatment. — Belladonna. — Spasmodic motion of the 
eyes. 

Gelseminm. — Eye-balls oscillate when using them. 

Hyoscyamus. — Quivering in the eye ; spasmodic closing of 
eye-lids. 

Spigelia. — Strabismus from nervous irritation. 

Strammoniinn. — Eyes wide open, staring ; brilliant, vacil- 
lating, rolling, squinting. 

I had a little patient that had strabismus following diph- 
theria, which readily yielded to gelsefniian and spigelia. 

MYOPIA. 

NEAR-SIGHTED. 

This affection is called short-sight, and depends either on 
an increase in the refractive power of the eye, or else on an 
elongation of its axis, so that in either case the rays of light 
are brought to a focus, before they reach the retina. This con- 
dition is usually congenital. It may be acquired. 

Treatment. — When congenital, medicines can have 
but little effect, but if caused by an inflammatory condition 
of the eyes, then the treatment laid down elsewhere for those 
conditions must be adopted. If congenital and ordinary type 
can only be seen at less than twelve inches, the vision is 
myopic and suitable glasses must be applied. 

Coniinn macnlatum. — Weakness of eyes ; short-sighted. 

Sulphur. — This should be tried in acquired cases, 



THEORY AND PRACTICE OF MEDICINE. 501 

PRESBYOPIA. 

LONG-SIGHTEDNESS. 

This depends apparently on a diminished quantity and 
density of the humors of the eye-ball, through which it be- 
comes flatter, and its refractive powers are diminished. It is 
one of the earliest signs of impaired nutrition in the aged. 

Treatment. — A regulation of the diet and habits of the 
patient, and the use of the following remedies, should be tried 
before having a resort to glasses. 

Belladonna. — Far-sightedness. 

Coninm. — Presbyopia, especially of far-sightedness of old 
persons when it comes on prematurely. 

Hyoscyamus. — Far-sighted, clear-sighted ; pupils dilated. 

Spigelia. — Dilated pupils ; far-sighted. 

INFLAMMATION OF THE EYE=LIDS. 

This affection begins on the margin of the eye-lids ; they 
become red, sore and swollen. 

Treatment. — Apis. — Bright redness; dread of light; 
lids feel sore, congested and swollen. Lids dark-red, swollen, 
excoriation of edges ; Edematous, with bag-like swelling 
under the eyes ; feel stiff. 

Hepar sulph. — Inflammation of the eye-lids ; sore to the 
touch ; lachrymation ; little pimples surrounding the inflamed 
eyes. 

Rhus tox. — Lids much swollen and inflamed ; the cheek 
under the eye is dotted with red pimples ; lids spasmodically- 
closed. 

HORDEOLUM 

STY. 

This is an inflammatory projection or boil on the margin 
of the eye-lids. 

Treatment. — Aconite. — For pain, inflammation and 
restlessness. 



502 THEORY AND PRACTICE OF MEDICINE. 

Calcarea carb. — As sties occur in debilitated persons, or 
of a strumous diathesis, calcarea carb. is a valuable remedy 
to ward them off or prevent their return. 

Lycopodium. — Sties generally appear on the upper lids, 
near the internal canthus. 

Phosphoric acid. — Inflammation of the eyes, and sty oh 
the upper lids. 

Pulsatilla. — This remedy is almost specific for sties, es- 
pecially on upper lids. 

Rims tox. — Inflammation of the lids, and sties on lower 
lids. 

Staphysagria. — Margins of lids dry, with hardened sties, 
or tarsal tumors. 

TARSAL OPHTHALMIA. 

GRANULAR EYE-LIDS — ECZEMA PALPEBRARUM. 

This is an inflammation causing a thick condition of the 
conjunctiva lining the lids. 

Symptoms. — The lids look red, rough and crusted 
with dry mucus, which cause an agglutination when sleeping. 
Treatment. — Clematis. — Chronic inflammation of the 
borders of the eye-lids, with soreness and swelling of the mei- 
bomian. 

Kali bichromicum. — Lids red, itching, tender ; tarsi seem 
rough, causing a sensation as from sand in the eyes ; granular 
lids ; edema of the lids, great desire to rub them. 

Mercurius cor. — Lids edematous, or erysipelatous; red, 
excoriated ; edges swollen, burning, smarting, edges covered 
with thick crusts or pustules. 

Pulsatilla. — Granular lids, dry, or with excessive bland 
secretion ; better in open air, but not in wind. 

Sulphur. — Ulceration of the margins of the lids. 

Zincum. — Upper lids heavy, as if paralyzed ; granular lids 
after ophthalmia neonatorum. 



THEORY AND PRACTICE OF MEDICINE. 503 

AGGLUTINATED EYE-LIDS. 

In this affection there is irritation or slight inflammation 
sufficient to cause an exudation of mucus which causes the 
lids to stick together during the night, and often have to be 
bathed before they can be opened in the morning: 

Treatment. — Calcarea carb. — Redness and swelling of 
the lids, sticking together at night ; scrofulous diathesis. 

Kali bichromicum. — Edema of the lids ; great desire to 
rub them ; lids agglutinated in the morning ; yellow matter 
in the canthi. 

Digitalis. — Agglutination of the lids in the morning ; dim- 
ness of vision ; things appear green or yellow (appear red — 
Bell ; black — Cap.) ; various colors before the eyes. 

Kali carbonicum. — Agglutination of lids in the morning ; 
spots, gauze, and black points before eyes ; swelling over the 
upper eye-lids in the morning, like little bags — under the lids, 
apis. 

Phosphorus. — Agglutination of the lids in the morning, 
with secretion of gum during the day. 

Mercurius. — Lids swollen, edges ulcerated and scabby. 

Rhus tox. — Inflammation of the lids, with agglutination in 
the morning. 

Sulphur.— Coldness of the lids ; agglutination of lids at 
night. 

VESICULAR LIDS. 

This condition is manifested by small vesicles or blisters 
forming on the lids. 

Treatment. — Apis. — Edematous, with bag-like swell- 
ing under the eyes, with vesicles. 

Euphrasia. — Lids swollen, with vesicles. 

Hepar sulphur. — Little pimples and vesicles surround the 
inflamed eye. 

Rhus tox. — Eye-lids edematous, or erysipelatous, with 



504 THEORY AND PRACTICE OF MEDICINE. 

scattered, watery vesicles ; meibomian glands enlarged, cilia 
fall out. 



FISTULA LACHRYMALIS. 

This signifies a fistulous aperture at the inner corner of 
the eye, communicating with the lachrymal sac. 

Symptoms. — The eye looks weak and watery, the 
tears flowing over the lid. The corresponding side of the nos- 
tril is dry, owing to the fact that the nasal duct is thickened or 
closed, which prevents the fluids from passing from the eye 
through the nose. The lachrymal sac distended with tears 
forms a small tumor by the side of the nose. At first the fluid 
is clear, but at last becomes muco-purulent. It may be 
squeezed upwards through the puncta, or if the obstruction is 
not complete, it may be pressed downward through the nose. 

Causes. — If not congenital, it may be induced by in- 
flammation of the lachrymal sac, and nasal duct. 

Prognosis. — If congenital the prognosis is unfavorable, 
yet a few cases may be benefited by dilating the nasal duct. 
If due to inflammation, then a large majority may be cured. 

Treatment. — I have cured several cases by homoeo- 
pathic treatment, even after the introduction of the style, or 
silver probe had failed. I cured two cases of seven and fifteen 
years standing. 

Calcarea carb. — Inflammation and closure of lachrymal 
ducts ; suppurating fistula lachrymalis. 

Nitric acid. — Fistula lachrymalis. 

Petroleum. — Inflammation of the lachrymal canal ; lach- 
rymal fistula. 

Pulsatilla. — Inflammation of the lachrymal apparatus, with 
profuse muco-purulent discharge and fistula lachrymalis. 

Silicea. — Inflammation of the lachrymal sac ; acute lach- 
rymal fistula. 



THEORY AND PRACTICE OF MEDICINE. 505 



DISEASES OF THE EAR. 

The ear is composed of three parts. 1. External ear. 2. 
Middle ear, or tympanum. 3. Internal ear, or labyrinth. 

The following plate shows some of the most important 
affections of the ear. 

''Otitis Externa. 
Boils or Abscesses. 
Accumulation of Wax. 
Diseases of the Ear <J Absence of Wax. 

Otitis Interni and Tympani. 

Deafness. 

Noises in Ear. 



OTITIS EXTERNA. 

INFLAMMATION OF THE EXTERNAL EAR. 

This is characterized by heat, redness and swelling of the 
mucous membrane of the external opening of the ear ; that 
is, between the meatus and drum of the ear. Noises in the 
ear, deafness and pain, followed by a discharge from the ear ; 
inflammation is followed by enlargement of the mucous fol- 
licles, and terminates in suppuration, ulceration, and the for- 
mation of scabs, or of painful granulations. 

This affection is apt to terminate in resolution, or it may 
assume the chronic form, accompanied by chronic deafness. 

Treatment. — Aconite in the first stages may often ar- 
rest the disease. If very painful, two drops of the 2x dilution 
in a teaspoonful of warm water may be put into the ear, and 
repeated every thirty to sixty minutes till pain subsides. 

Belladonna. — Tearing in right external ear and whole 
right side of face ; pinching in ears, first right, then left. 

Pulsatilla. — This is the great ear remedy. Otalgia, with 



506 THEORY AND PRACTICE OF MEDICINE. 

darting, tearing pains, and pulsating at night External and 
meatus red and swollen. 

Sulphur. — Chronic inflammation, and when the disease is 
very apt to return. Ears very red. 

BOILS OR ABSCESSES. 

Boils or abscesses often form within the meatus. They 
are very tender or painful, but lead to no serious trouble. 
Their presence is diagnosed by their closing the meatus. 

Treatment. — Belladonna, hepar sulphur 'and silicea are 
all beneficial at certain stages. Belladonna to arrest their 
formation, but if they cannot be arrested, then hepar sulphur 
will hasten suppuration. If the ear is very painful and the 
aconite and warm water put in the ears, as recommended 
under the head of external inflammation, then a small bit of 
cotton containing a few drops of chloroform wrapped in a 
piece of dry cotton and placed within the meatus and covered 
with paper, will often give immediate relief for a short time. 

ACCUHULATED WAX. 

Sometimes patients complain of being deaf, and hear a 
cracking sound in the ear when pressing it. The speculum 
often reveals the ear filled with hard, dry wax. 

Treatment. — I order the ear filled with warm olive 
oil and let it remain several minutes, and syringe the ear 
with a small ear syringe and warm water until the wax is 
loosened and washed out. 

The following remedies will usually prevent the accumu- 
lation of wax in the ears. 

Conium maculatum. — Painful, sensitive of hearing ; ears 
feel as if stopped up ; accumulation of ear-wax, looking like 
decayed paper, mixed with pus or mucus. 

Petroleum. — Dryness and disagreeable sensation ; wax in- 
creased, thick or thin ; discharge of blood and pus from the 
ear. 



THEORY AND PRACTICE OF MEDICINE. 507 

Absence of Wax. — Graphites. — Loss of hearing, with 
dryness of the ears ; sensation as if a skin was before the ears. 

Lachesis. — Hardness of hearing with want of wax ; dry- 
ness in the ears ; numbness about the ear and cheek. Ear- 
wax too hard, pale and insufficient. 

OTITIS INTERNA AND TYMPANI. 

INFLAMMATION OF THE INTERNAL AND MIDDLE EAR. 

There is such an intimate connection existing between 
the internal and middle ear, and as inflammation can scarcely 
attack one without involving both, I will treat them as one, 
for the remedies that are indicated for one are applicable for 
the other. 

These diseases manifest themselves by pain in the internal 
and middle ear, extending to head, face and throat. There 
is a throbbing sensation in the ear with roaring and deafness. 
The fever is often high, face flushed, patient is restless, sleep- 
less, and often delirious. If the disease is not early arrested 
an abscess forms, and the membrana tympani is perforated. 
If the perforation is small, there is no damage to the hearing, 
but if the aperture is large then the hearing may be entirely 
lost. With prompt and judicious treatment a large majority 
can be cured without much damage to the hearing. Inflam- 
mation of the ear may be acute or chronic, but as they are 
similar except in the severity of the acute symptoms I will 
treat of the .11 as one. 

Diagnosis. — A child often complains of pain in the ear 
when it is a reflex from a decayed tooth ; by running the finger 
along the angle of the jaw, if the tooth is involved there will 
be a tender cord passing to the ear. After an abscess breaks 
the ear should be cleansed and examined through a speculum 
and a bright light when the rent in the drum may be plainly 
seen ; but, as often happens, the perforation is barely large 
enough to permit the pus to flow from the internal ear. If, in 
that case, and in doubt, we place one end of a rubber tube in our 



508 THEORY AND PRACTICE OF MEDICINE. 

own ear, and the other end in the affected ear of the patient, 
and inflate the eustachian tube with the politzer bag, if there 
is a perforation we feel the air in our own ear. 

Treatment. — Our first object is to try to arrest inflam- 
mation and prevent abscess. 

Aconite. — For fever, pain, heat in ear, and restlessness. 

Arsenicum iodatum. — Otitis, with fetid corrosive discharge. 

Belladonna. — Face and eyes red with congestion to the 
head. 

Chamomilla. — Pain almost unbearable, and child fretful 
and wants to be carried all the time. 

Mercurius. — Pains extend to the teeth, and are worse in a 
warm bed. 

Pulsatilla. — Darting, tearing pains ; inflammation follow- 
ing measles. 

Warm local applications are often beneficial to give a few 
moments temporary relief. 

If an abscess bursts, and perforation of the tympanum takes 
place, then our whole effort must be put forth to try to heal 
the rent. The ear must be gently syringed out with warm 
carbolized water. Too much force must be avoided lest the 
rent might be enlarged, and then again we must avoid filling 
the internal ear with water, unless the rent is large to permit 
the wash to flow out again. Immediately after washing out 
the ear the politzer bag should be used several times so as to 
cleanse the internal ear of water and pus. The washing and 
politzer should be used often enough to keep the edges of the 
rent in the tympanum free from pus or other irritating secre- 
tions. The patient may be taught to blow air through the 
eustachian tube by holding his nose tightly, close the mouth, 
and then make an effort to expel the air from the lungs, and 
as it has no other outlet it must pass into the internal ear and 
out through the perforation in the tympanum. In this way 
the internal ear can be kept clean. After each washing the 
ear should be thoroughly dried with absorbing cotton on a 
probe, and by means of a small rubber bag with a tube the ear 



THEORY AND PRACTICE OF MEDICINE. 509 

can be dusted with compound sterated sine. This is drying 
and healing and prevents the excretion of mucus. 



OTORRHCEA. 

RUNNING OF THE EAR. 

This is characterized by an offensive discharge from the 
ear. It is usually a chronic condition following inflammation. 
The ear is tender ; rough handling causes pain, the child is 
constantly putting its hand to the ear. Deafness is apt to fol- 
low in many cases. 

Treatment. — The internal ear must be treated upon 
the same general principles as laid down in perforation of the 
tympanum. If the rent is small and the otorrhcea is checked, 
the patient may hear fairly well ; but if the perforation is 
large, and of long standing, then there is but little hope. 

I have relieved several cases of otorrhcea and roaring in 
ears of from eight to ten years standing ; so we can never tell 
the full capability of the law of similia until fairly tested. I 
mention some of the most appropriate remedies alphabetically, 
but the remedy must always be selected by the totality of the 
symptoms. 

Arsenicum. — Roaring in the ears, with each paroxysm of 
pain. Discharges of cadaverous odor, profuse, ichorous. 

Arsenicum iodatum. — Fetid corrosive discharge from the 
ear following otitis. 

Aurum metallicum. — Caries of the mastoid process; ob- 
stinate otorrhcea. 

Calcaria carb. — Purulent, offensive discharge from the ears ; 
in the scrofulous diathesis. 

Capsicum. — Valuable remedy in chronic suppuration of 
the ears, with bursting headache, chilliness ; suppuration of 
the middle ear, with perforation of the drum, and discharge 
of yellow pus ; particularly in mastoid disease, with tender- 
ness over the petrous bone, threatening to involve the menin- 
ges of the brain. 



5IO THEORY AND PRACTICE OE MEDICINE. 

Causticum. — Feeling of obstruction in the ears, with offen- 
sive purulent discharge. 

Kali brochromicum. — Thick, yellow, fetid discharge from 
both ears. 

Mercurius. — Tearing pains, thick, bloody fetid discharge ; 
glands swollen. 

Nitric acid. — Eustachian tubes obstructed, terribly offen- 
sive, purulent otorrhoea. 

Petroleum. — Eustachian tubes affected, causing whizzing, 
roaring, cracking, with hardness of hearing ; discharge of 
blood and pus from ear. 

Silicea. — Ringing, or roaring in the ears, otorrhcea ; offen- 
sive, watery, curdy, with soreness of inner nose and crusts on 
upper lip ; after abuse of mercury ; caries. 

Tellurium. — Vesicular eruption on membrane, then sup- 
puration and perforation ; membrana tympani permanently 
injured and hearing greatly diminished. 

The patient's general health and diet must be looked after. 



DEAFNESS AND HARDNESS OF HEARING. 

There are many varieties of this affection and many causes. 
I need not go into detail as the indicated remedy will tell the 
variety. 

Diagnosis. — Mr. Hinton gives the following distinction 
between deafness from nerve affection and tympanic lesion. 
He says : The chief means of distinction is the tuning-fork, 
used in certain ways ; the only drawback to its value being 
the fact that a certain number of persons, otherwise of good 
hearing, are unable to hear it when placed upon the head ; 
but this is not often of consequence. 

i. In a normal state a tuning-fork is heard before the 
meatus after it has ceased to be heard on the vertex. 

2. When placed on the vertex, it is heard more plainly 
when the meatus is closed. 



THEORY AND PRACTICE OF MEDICINE. 5II 

3. Consequently, when one meatus is closed, the tuning- 
fork is heard most plainly in the closed ear. 

Consequently, says Hinton, in cases of disease, the follow- 
ing inferences seem justified. 

1. In case of one-sided deafness, if the tuning-fork when 
placed on the vertex, is heard more plainly in the deaf, or more 
deaf-ear, the cause is seated in the conducting apparatus ; if it 
is heard loudest in the better ear, the cause is probably in 
some part of the nervous apparatus. 

2. If on closing the meatus, the tuning-fork is heard de- 
cidedly louder, there is no considerable impediment to the pas- 
sage of sound through the tympanum. 

3. If the tuning-fork is heard louder on the vertex, than 
when placed close before the meatus, the cause of the deafness 
is in the conducting media. 

4. However imperfect the tuning-fork may be heard when 
placed on the vertex, it gives reason for suspecting only and 
is not proof of a nerve affection. 

When a tuning-fork is not at hand the ticking; of a watch 
placed in the same positions as recommended by Mr. Hinton 
for the tuning-fork will answer every purpose. In making out 
our diagnosis as to the degree of deafness we must be governed 
by the distance a watch is heard ticking from the ear. 

Prognosis. — We must be guarded in our prognosis, 
for there are many circumstances to be taken into considera- 
tion before we can be able to give an intelligent opinion as to 
the curability or the non-curability of any case. If the deaf- 
ness is due to heredity, and if the drum of the ear has been 
destroyed by disease, then there is no hope of restoring the 
hearing. But if the tympanum has not been perforated, and 
it is in a fairly healthy condition ; if there is thickening of 
the eustachian tubes, or accumulation of mucus from nasal or 
pharyngeal catarrh ; if deafness is caused by acute diseases, 
and from nervous conditions, then we can hold out fair hopes 
for the restoration of the hearing. 

During my long experience, I have restored many cases 



512 THEORY AND PRACTICE OF MEDICINE. 

to fairly good degree of hearing, which had been considered 
hopeless. My own case is proof of this fact. I feel confident 
that I would be incapable of attending to business to-day, had 
I not become acquainted with homoeopathy, and saved by 
that treatment. It is a remarkable fact that there is only 
about one out of every five persons that has perfect hearing 
in both ears. 

Treatment. — In the treatment of deafness, we must 
look after the cause. If the trouble is in the eustachian 
tubes, or from catarrhal troubles, etc., we must look after those 
conditions. Under the head of deafness I will only mention 
the characteristics of the remedies for that condition, and re- 
serve those for dullness of hearing and roaring in the ears for 
a separate article. 

Arnica. — Deafness from concussion. 

Arsenicum. — Hardness of hearing ; cannot hear the voice. 

Arsenicum iodatum. — Catarrhal inflammation of the throat, 
nose and middle ear ; swelling of the tissues within the nose ; 
hypertrophied condition of the opening of the eustachian tube 
and increasing deafness. Chronic irritability of the middle 
ear following scarlet fevers ; thickening of the tympanum. 

Belladonna. — Extreme sensibility of hearing; deafness, 
as if a skin were drawn over the ears. 

Cactus grandiflorus. — Hardness of hearing from conges- 
tion ; pulsation in the ears ; noise like running water, or buz- 
zing ; after otitis. 

Calcarea carb. — Deafness ; scrofulous inflammations of 
the ear, with muco-purulent otorrhoea, enlarged glands ; 
chronic inflammation of ear, thickening of the drum. 

Gelsemium. — Deafness, the result of catarrh of the mid- 
dle ear and eustachian tube ; several brilliant cures have been 
made by it. Deafness resulting from quinine has been cured. 

Graphites. — Deafness, consequent upon catarrh of the 
middle ear, with feeling as if a membrane covered the ear, or 
with sensation of valves opening and shutting, and cracking 
on swallowing, especially with eruptions behind the ears. 



THEORY AND PRACTICE OF MEDICINE. 5x3 

Hydrastis. — Catarrhal inflammation of the middle ear and 
deafness from scarlet fever. Otorrhoea, with thick mucus 
discharge. 

Iodnm. — Chronic deafness, with adhesions in the middle 
ear or granular enlargement ; deafness, with chronic catarrh 
of the eustachian tube, inflammation of the tonsils, roaring in 
the ears. 

Kali bichromicum. — Deafness from chronic suppurative 
perforation of the drum, and discharge of yellow tenacious 
pus ; eczema of the ears externally, with oozing. 

Mercurius. — A valuable remedy for acute and chronic 
catarrh of the tympanum involving the eustachian tube, with 
deafness, enlarged glands. 

Natrum muriaticum. — Chronic catarrh of the ear, with 
deafness and various noises, especially cracking when chewing. 

Nux vornica. — Deafness, with roaring ; auditory canal dry 
and sensitive, with coryza; itching in the eustachian tube, 
headache, nausea, creeping chills. 

Petroleum. — Deafness, with frequent occipital headache, 
tearing pains in the ears, as if water were in them ; pain in the 
eustachian tubes, with noises in the ears and deafness. 

Pulsatilla. — Deafness, with feeling as though the ears were 
stopped, or sometimes with pulsation in the ear as from a pulse, 
nervous deafness, hears better when there is noise, from cold 
after having hair cut. 

Silicea. — Deafness in consequence of inflammation ; caries 
of the mastoid ; inflammation in middle ear, with hissing 
sound ; the discharges from the ear are generally curdy and 
ichorous. 

Sulphur. — Deafness, with a variety of inflammations in ex- 
ternal and middle ear, and perhaps also in the internal ear. 



35 



514 THEORY AND PRACTICE OF MEDICINE. 

NOISES IN EAR. 

This is a condition with a variety of sounds. There is 
roaring- like the ocean, hissing like steam, and warbling- and 
chirping like insects. 

Treatment. — Cactus. — Noise in ear like running water 
or buzzing. 

Calcarea phosphorica. — Difficult hearing ; singing and 
other noises, mostly in the right ear. 

Causticum. — Buzzing, roaring in ears, with re-echoing of 
sounds. 

China. — Rinoqng- and roaring in the ears, loss of hearing-; 
hearing extremely sensitive to noises. Give it high. 

Digitalis. — Buzzing or noises like a steam-engine. 

Graphites. — Reverberations in the ear, even his own words 
and even* step : hissing, ringing, rushing, roaring, cracking, 
or clucking sounds in the ears ; violent nocturnal roaring ; 
ears feel stuffed at times ; sound of rolling thunder before ears ; 
snapping in the ear after even" eructation, as if air penetrated 
the eustachian tube. 

Hepar sulphuris. — Whizzing and throbbing in the ears, 
with hardness of hearing. 

Ignatia. — Sensitiveness to sounds; sound before the ear, 
as from a strong wind ; hard hearing except for speech. 

Iodum. — Hearing- first sensitive to noise : buzzing- in ears. 

Strammonium. — Sensation as of wind rushing out of ear. 

Sulphur. — Roaring in the ears in evening in bed, with rush 
of blood to the head ; ringing in head coming out at ears. 

Veratrum viride. — Roaring in ears ; congestion 
vomiting. 



THEORY AND PRACTICE OF MEDICINE. 



515 



GENERATIVE DISEASES. 



Under this head I will only treat of female diseases be- 
longing to the general practitioner without any reference to 
gynecological operations. 



Amenorrhoea Suspended Menstruation. 

Dysmenorrhea Painful Menstruation. 

Menorrhagia Excessive Menstruation.. 

Hysteralgia Irritable Uterus. 

Metritis Inflammation of the Uterus. 

Vaginitis Inflammation of the Vagina. 

Leucorrhoea The Whites. 

Metrorrhagia Hemorrhage bom the Uterus. 

Puerperal Peritonitis. .Child-bed Fever.. 



Female 
Diseases. 



Ovaritis 



AriENORRHCBA. 

SUSPENDED MENSTRUATION. 

Under this head may be noticed the following varieties of 
amenorrhcea : Suppressed ; irregular ; scanty ; recurring too 
early ; lasting too long ; vicarious, and cessation at the criti- 
cal age. 



Symptoms. — Delay of the First. — Girls complain 
of back-ache, dark circles around the eyes, and some headache.. 

Treatment. — Natrum muriaticum. — First menses de- 
layed ; amenorrhcea. Before menses, anxious, sad, qualmish ;; 
sweetish eructations in the morning ; headache ; eyes heavy, 
palpitation. 

Pulsatilla. — Amenorrhcea at puberty, with nose-bleed, 
headache, colic, back-ache, gastric catarrh ; tearful melan- 
cholia, general chilliness. 



516 THEORY AND PRACTICE OF MEDICINE. 

Sepia. — Amenorrhoea at the age of puberty or later ; de- 
layed menstruation. 

Sulphur. — Delayed and difficult first menstruation. 

When there are symptoms of the approach of the menses, 
but tardy, a warm sitz bath in connection with the medicine 
will hasten its arrival. If the girl is anaemic or chlorotic, then 
she must be treated for those conditions. 

Suppressed Menstruation. — When once the catamenia 
has been established and it is stopped by cold, wet feet, 
mental shock, or any other cause, it is called amenorrhoea 
suppressa — suppressio mensium — suppressed menstruation. 

This sometimes leads to serious results to the health of 
the individual. There is often fever, nausea, headache, back- 
ache, etc. 

Treatment. — Aconite. — Feverish ; suppression of the 
menses from fright. 

Colocynthis. — Suppression of menses, caused by chagrin. 

Conium maculatum. — Menses suppressed ; too late and 
scanty. 

Dulcamara. — Suppression of the menses from cold. 

Lycopodium. — Suppression of menses from fright ; delay 
of the the first menses. 

Opium. — Amenorrhoea from fright ; irresistible drowsi- 
ness ; eclampsia, or appearance of flashing of light. 

Podophyllum. — Suppressed menses in young females, with 
pain from motion ; better from lying down. 

Pulsatilla — Menses suppressed, or flow intermittingly ; 
after getting feet wet ; in chlorosis ; from nervous debility ; 
with throbbing headache ; pressure in stomach ; pain in 
uterus ; dysuria ; ophthalmia ; morning nausea ; or bad taste 
in mouth. 

Irregular or Infrequent Menstruation. — This is the 
condition in which the menses are regular at one time, and at 
the next they are too late. 



THEORY AND PRACTICE OF MEDICINE. 517 

Treatment. — China. — Profuse and consisting of dark 
lumps. 

Conium maculatum. — Menses suppressed, too late ; scanty. 

Cyclamen Europceum. — Menses suppressed or scanty. 

Dulcamara. — Menses too late, too short ; bloody, watery, 
thin. 

Iodum. — Menses irregular ; sometimes too early, at others 
too late ; premature, violent and copious. 

Nux moschata. — Menses, irregular in time and quantity ; 
flow generally dark, thick ; bearing down in abdomen, with 
drawing in limbs ; pains from small of back downward ; un- 
conquerable drowsiness, mouth dry, hysteric laugh. 

Pulsatilla. — Menstruation too late, scanty and of short du- 
ration ; flow thick, black, clotted ; or thin, watery ; or change- 
able in appearance ; flows more during day while walking. 

Sulphur. — Menses too late ; of short duration ; or sup- 
pressed ; blood thick, dark, acrid, sour smelling ; makes the 
thighs sore. 

Menses Scanty. — Aconite — Menses too scanty, or sup- 
pressed lochia in plethoric females. 

Baryta carb. — Menses scanty, lasts only one day ; before 
menses, toothache, swollen gums, colic with swelling of the 
limbs. 

Conium maculatum. — Menses ; suppressed ; too late and 
scanty. 

Cyclamen Europceum. — Menses suppressed or scanty, and 
painful ; dread of fresh air ; after menses, swelling of mammae, 
with secretion like milk. 

Graphites. — Menses too scanty, with colic. 

Natrum muriaticum. — The menses delay, and growing 
more and more scanty ; very sad and gloomy during the 
menses, with palpitation of the heart, and morning headache. 

Phosphorus. — Menses too early and scanty, with constitu- 
tional debility ; chronic diarrhea ; tendency to chest diseases. 

Sepia. — Menses too late and too scanty ; suppressed. 



51 8 THEORY AND PRACTICE OF MEDICINE. 

s Menses Recurring too Early, or Lasting too Long. 
— Calcarea carb. — Catamenia too early and too profuse. The 
least excitement causes the menses to return; during the 
menses vertigo, rush of blood to the head, toothache and cold, 
damp feet. 

Calcm-ea phosphorica. — Menses too early, blood bright, 
with girls ; too late, blood dark, or first bright, then dark, 
with women. 

Causticum. — Menses too early and too profuse, and after 
ceasing, a little is passed from time to time for days ; smell 
badly and excite itching of the vulva ; only during the day. 

Ignatia. — Menses scanty, black, of a putrid odor. 

Iodum. — Menses, sometimes too early, at others too late 
premature, violent and copious. 

Ignatia. — Menses, too soon ; scanty or too profuse. 

Natrunt carbonicum. — Menses too early and long lasting 
accompanied by tearing headache ; nervous, can not bear 
music ; worse in a thunder storm. 

Nux vomica. — Menses too early and profuse ; flow dark 
over-sensitiveness to nervous impressions ; faints easily. 

Phosphorus. — Menses early, profuse, long lasting ; or early 
scanty and pale ; weeps before the menses ; during menses 
pains in the small of the back ; palpitation.' 

DYSMENORRHEA. 

PAINFUL MENSTRUATION. 

This is a condition in which a female often suffers intense 
pain before, during, or after the flow of the menses. 

Treatment. — Belladonna. — Painful menstruation, and 
great pressing towards the genitals, as if everything would 
protrude ; face red. 

Canlophyllum. — Painful menstruation ; the flow being nor- 
mal in quantity ; spasmodic dysmenorrhcea ; spasmodic, in- 
termittent pains in bladder, stomach, broad ligaments, conges- 
tion and irritability of the uterus ; scanty flow. 



THEORY AND PRACTICE OF MEDICINE. 519 

Chamomilla. — Dysmenorrhoea, with labor-like pains ; dis- 
charge dark and clotted, with tearing pains in the legs. 

Cimicifuga. — -Menses, profuse, early, dark ; blood coagu- 
lated ; scanty, slightly coagulated ; sharp pains across abdo- 
men ; has to double up ; labor-like pains ; debility between 
periods ; scanty flow between menses ; suppressed by mental 
emotions ; from cold ; from fever. 

Cocculus. — Menstrual, colic ; the pains are spasmodic and 
irregular ; dysmenorrhoea, always followed by hemorrhoids. 

Gelsemiiim. — Dysmenorrhoea, preceded by sick headache, 
vomiting ; congestion to head ; deep red face ; bearing down 
in the abdomen. 

Hamamelis virginica. — Dysmenorrhoea, with severe pains 
through the lumbar and hypogastric region and down the 
legs ; pain in head causing stupor, deep sleep. 

Secale comutiim. — Menses too profuse, and lasting too 
long; with tearing and cutting colic, cold extremities, cold 
sweat, great weakness, and small pulse ; with violent spasms. 

Xanthoxylum. — Neuralgic dysmenorrhoea, pains going 
down the anterior portions of the thighs, mostly left-sided ; 
neuralgic headaches, great bearing down in the abdomen, 
pains in the back, and down the legs, menses very scanty, 
thick, almost black. 

I wish to advise young practitioners never to dilate the 
os rteri with instruments for the relief of dysmenorrhoea until 
medicines have failed to cure. I can say to the praise of homoe- 
opathy, that I have cured many and all cases that came under 
my observation. Some of them were desperate cases. I have 
never used an instrument to dilate the os uteri since I have 
been a homceopathist. The indicated remedy should be given 
a week before the expected monthlies. 

HENORRHAQIA. 

EXCESSIVE MENSTRUATION. 

This includes all conditions of menstruation as to time, 
quantity, and character of the flow, over and above the nor- 



520 THEORY AND PRACTICE OF MEDICINE. 

mal conditions. I need not consume time by giving the 
various symptoms, for as I repeat the remedies it will be read- 
ily seen what condition each patient is in. The drain makes 
telling inroads upon the constitution, unless speedily arrested. 

Treatment. — Aconite. — Profuse menses, in plethoric 
females and young girls. 

Belladonna. — Profuse discharge of hot, bright red blood ; 
sometimes dark, clotted, and of bad odor ; bearing down in 
the abdomen and womb. 

Calcarea phosphoricum. — Menses every two weeks, black 
and clotted. 

Chamomilla. — Profuse discharge of dark and clotted blood, 
flowing at intervals ; frequent desire to pass urine. 

Cimicifuga. — Discharge dark and coagulated ; severe pain 
in the back, and down the thighs ; aching across the hips and 
pressing down in the uterus. 

Crocus saliva. — Menses profuse and lasting too long, but 
come at proper time ; blood clotted, stringy. 

Ignatia. — Menses too frequent, profuse, and long lasting; 
menstrual blood black, of putrid odor, in clots ; patient seems 
full of grief, frequent sighing. 

Iodum. — Menses premature, copious and violent, with 
great weakness ; emaciation, with a good appetite. 

Nux moschata. — Menses too early and profuse, with dis- 
charge of thick, black blood ; tongue and mouth dry, especially 
after sleeping. 

Nux vomica. — Menses too early and too profuse ; discharge 
dark-colored blood ; the flow after continuing several days, 
stops and returns. 

Platina. — Too long and profuse menstruation ; discharge 
partly fluid and partly in clots ; great pressing down in the 
genitals. 

Sabina. — Menses profuse and debilitating; discharge 
partly pale-red and partly clotted blood ; drawing, tearing 
pains from the back through to the pubes; very nervous and 
hysterical. 



THEORY AND PRACTICE OF MEDICINE. 521 

Secale comutum. — Too profuse and long-continued menses ; 
discharge dark, liquid blood, increased by motion ; suitable to 
thin, scrawny women. 

Sulphur . — The menses last too long ; the patient seems 
almost well, and then it returns again, and again ; constant 
heat on top of head. 

Trillium. — Menses at first bright-red, but grow pale, last- 
ing too long; sometimes profuse hemorrhages. 

Ustilago. — Flooding lasts for weeks ; blood dark-colored, 
with many clots, and vertigo ; dull, heavy headache. 

In the treatment of this affection the physician has a good 
opportunity of displaying his skill in diagnosing the remedies; 
for it will be seen that each have their own grand charac- 
teristics, corresponding with the symptoms of each case. 

HYSTERALGIA. 

IRRITABLE UTERUS. 

This means a hyperesthesia, or an exalted irritability and 
morbid sensibility of the nerves of the womb and its append- 
ages. I think that nine-tenths of hysterical and nervous 
affections of females may be traced to an irritable uterus. 

Treatment. — Belladonna. — Great pressing towards the 
genitals, as if everything would protrude. 

Caulophyllum. — Sensation, as if the uterus was congested, 
with fullness and tension in the hypogastric region. 

Cimicifuga. — Bearing down in uterine region and small of 
back, limbs feel heavy ; great tenderness on pressure over the 
uterine region. 

China. — Congestion of the uterus, fullness, pressing and 
heaviness, worse when walking. 

Conium maculatum. — Stinging in the neck of the uterus ; 
burning, sore, aching sensation in the region of the uterus. 

Graphites. — Pain in uterus when reaching high with the 
arms ; bearing down pain in the uterus to the back, with 
weakness and sickness. 



522 THEORY AND PRACTICE OF MEDICINE. 

Helonias dioica. — Profound melancholy, deep undefined 
depression, with a sensation of soreness and weight in the 
womb. 

Lilium tigrinum. — Severe neuralgic pains in uterus ; 
could not bear touch, not even weight of bed-clothes, or slight- 
est jar. 

Platina. — Painful sensitiveness and continual pressure in 
region of mons veneris and genital organs ; induration of 
uterus. 

Rhus tox. — Bearing down, when standing or walking ; 
back-aches, better lying on something hard ; prolapsus from 
over-exertion or straining. 

METRITIS. 

INFLAMMATION OF THE UTERUS. 

This disease may be either acute or chronic, and involves 
the whole of the womb. When inflammation attacks the in- 
ternal membranes of the uterus, it is called endometritis. 
But as the general treatment is about the same, I will include 
them under one head, and refer the student to works on gyn- 
ecology for local treatment of endometritis. Acute and 
chronic metritis have similar symptoms, except the latter is 
milder in degree. 

Symptoms. — The patient first complains of a fullness, 
heat and irritation of the uterus. Sometimes rigors precede 
the fever ; the lower abdomen is tender on deep pressure, and 
as the disease progresses the bowels become tender and tym- 
panitic, thus showing that the appendages of the womb are 
involved ; nausea and vomiting are often present. 

Diagnosis. — Moderate pressure over the whole abdo- 
men causes pain in simple peritonitis, but deep pressure above 
the pubes shows tenderness and pain deep in the pelvis when 
the womb is involved. If in doubt, then a digital examina- 
tion per vaginum reveals an enlarged, spongy and tender 
uterus, thus leaving no doubt as to the character of the dis- 



THEORY AND PRACTICE OF MEDICINE. 523 

ease. Cancer may be diagnosed by the hard, stony feel, and 
enlarged os uteri. Cauliflower excrescence may be known by 
the craggy appearance of the tumefaction, which bleeds by 
rough handling. 

Treatment. — Aconite. — This is one of the first reme- 
dies suggested in all inflammatory conditions, and yet a judi- 
cious homceopathist will select his remedy in accordance with 
the totality of the symptoms. Aconite has cutting, lancinat- 
ing, burning and tearing pains in the uterus, with anguish 
and fear ; intense thirst, and full bounding pulse. 

Arnica. — Is called for if inflammation is the result of a 
blow or concussion. 

Arsenicum. — Burning, lancinating pains ; the parts burn 
like fire ; great restlessness and fear of death ; drinks often, 
but little at a time. 

Belladonna. — Tenderness of the abdomen, the least jar or 
motion causes suffering ; pains excruciating and bearing down ; 
headache and intolerance of light and noise. 

Cantharis. — -Great heat and burning in the abdomen ; con- 
stant painful urging and tenesmus of the bladder, passing but 
a few drops at a time, sometimes mixed with blood. 

Colocynth. — Colic, feeling as if the intestines were being 
squeezed between stones ; vomiting and diarrhea. 

Hyoscyamus. — Spasmodic jerking of the limbs, face, and 
eye-lids ; furious delirium, with wild, staring look ; mutter- 
ing, and picking at the bed-clothes ; wants to be naked. 

Ipecac. — Cutting pains, continual nausea and vomiting; 
green, watery, fermented stools. 

Lachesis. — Can not bear any pressure, not even the cloth- 
ing over the uterine region ; the pain in the uterus is relieved 
for a time by a flow of blood, but soon returns ; abdomen 
distended. 

Mercurius. — Lancinating, boring or pressing pains in the 
genital organs ; tongue moist, with great thirst ; green, slimy 
mucus stools with violent tenesmus. 

Pulsatilla. — After taking cold ; frequent chilliness, even 



524 THEORY AND PRACTICE OF MEDICINE. 

in a warm room ; metritis, with suppression of the lochial or 
menstrual discharge; contractive or labor-like pains in the 
uterus ; nightly diarrhea. 

Warm applications to the lower abdomen, and a vaginal 
douche of warm carbolized water, are often grateful and bene- 
ficial to the patient. 

VAGINITIS. 

INFLAMMATION OF THE VAGINA. 

Symptoms. — The vagina has a dry burning sensation ; 
very tender and often hot and painful ; pulse full and bounding. 
Diagnosis. — Redness and tenderness of the vagina dis- 
tinguish vaginitis from other diseases of the female organs. 

Prognosis. — This is sometimes grave ; fortunately it is 
a rare affection, except in parturient women. I have seen it 
in girls of five to fifteen years of age, and found it much more 
difficult to manage than that occurring in married women. 

Treatment. — Berberis. — Sensation of burning and sore- 
ness in vagina, painful to touch. 

Calcarea carb. — Itching or pressing in the vagina, con- 
stant aching ; inflammation and swelling of the genitals. 

Ferrnm. — Swelling and indurations in the vagina, too dry, 
and prolapsus. 

Graphites. — Subacute or chronic inflammation of vagina 
and neck of uterus ; vesicles or excoriation in the vagina ; it is 
cold. 

Hamamelis virginica. — Vaginitis, intense soreness, and 
great tenderness of the vagina. 

Merairhis. — Inflammation of the vagina, and still more of 
the external genitals ; prolapsus of the vagina, with sensation 
of great rawness. 

Sulphur. — Catamenia thick, black, acrid, making the parts 
sore ; burning, painful leucorrhcea, making the parts sore 

Thuja. — Vagina extremely sensitive. 

If the vagina is not too tender, it may be washed out once 



THEORY AND PRACTICE OF MEDICINE. 525 

or twice a day with equal parts of warm water and milk ; 
a warm solution of tincture of hamamelis and water. Carbo- 
lized warm water is also an excellent wash. 



LEUCORRHCEA. 

THE WHITES. 

This is a mucus discharge from the vagina of various colors 
and consistencies, as will be seen as I give the grand charac- 
teristic of the different remedies. 

Treatment. — Aluminum. — Profuse, purulent, yellow- 
ish, corroding discharge, relieved by cold applications. 

Ambra. — Discharge of bluish-white mucus, only at night. 

Ammonium muriaticum. — Discharge like the white of 
egg, preceded by a pinching pain around the navel ; brown 
slimy leucorrhcea. 

Arsenicum. — Acrid, corroding leucorrhcea, making the 
parts sore ; discharge thick, yellow ; dropping out while 
standing. 

Bovista. — Discharge like the white of egg, coming away 
while walking ; also yellowish-green and corrosive. 

China. — Bloody leucorrhcea, with occasional discharge of 
black clots, or fetid purulent matter. 

Cocculus. — Discharge like serum, mixed with purulent, 
ichorous liquid. 

Conium. — Leucorrhcea ; smarting and excoriating the 
parts ; discharge whitish or milk-colored and painful. Indur- 
ation or ulceration of the os uteri. 

Ignatia. — Purulent, corrosive leucorrhcea, with a weak, 
empty feeling in the stomach. She seems full of suppressed 
grief. 

Kali bichromicum. — Yellow, ropy leucorrhcea, which can 
be drawn out in long strings. 

Kreosotum. — Putrid, acrid, corrosive leucorrhcea, with 
great debility. 



526 THEORY AND PRACTICE OE MEDICINE. 

Lachesis. — Discharge copious, smarting, slimy, stiffening 
the linen, and staining it green. 

Nux vomica. — Fetid leucorrhcea, tinging the linen yellow, 
with pain in the uterus as if sprained. 

Podophyllum. — Discharge consisting of thick, transparent 
mucus ; prolapsus uteri and ani. 

Pulsatilla. — Burning ; thin acrid leucorrhcea ; milky leu- 
corrhcea, with swelling of the vulva. 

Sabina. — Excoriating leucorrhcea, with much pruritus ; 
discharge ropy, glassy. 

Sepia. — Yellowish, watery, milk-like or mucus leucorrhcea. 
Dirty yellow spots on the face ; very fetid urine, depositing a 
clay-colored sediment. 

Sulphur. — Burning, painful leucorrhcea, making the parts 
sore ; discharge thin, yellowish, preceded by pinching in the 
hypogastrium ; burning in the vagina ; constant heat on top 
of the head. 

I have had very gratifying success with ova testa 3X, in 
leucorrhcea of a whitish discharge. I have found good results 
by washing out the vagina, with a solution of hydrastis cana- 
densis, tincture of calendula, borax and carbolized water. 
Either of the tinctures mentioned may be used in the strength 
of twenty to thirty drops to a pint of tepid or cold water, 
whichever is most agreeable. 

If the case is simple vaginal leucorrhcea, the above treat- 
ment will usually cure. If they do not relieve, then we may 
suspect uterine leucorrhcea, as the result of chronic endome- 
tritis, which will require local treatment to the internal organ. 

flETRORRHAGIA. 

HEMORRHAGE FROM THE UTERUS. 

This has reference to hemorrhage from the unimpregnated 
uterus. I may mention that the remedies given under met- 
rorrhagia are also applicable to hemorrhage after miscarriage, 
during abortion, and post partum hemorrhages. If, however, 



THEORY AND PRACTICE OF MEDICINE. 527 

there is any uterine obstruction to hinder the contraction of 
the womb, such as polypus, fibroid, placenta, and clots, they 
must be removed before the hemorrhage can be arrested. 

Treatment. — Aconite. — Persons of full habit, especially 
young girls. Active hemorrhage, with fear of death ; very 
restless and anxious. 

Belladonna. — Profuse bright-red blood, which feels hot to 
the parts ; violent pressing downward as if everything would 
escape through the vulva. 

Bryonia. — Discharge of dark-red blood in large quantities, 
with violent back-ache ; nausea and faintness on sitting up in 
bed ; worse when moving. 

Chamomilla. — Dark, coagulated blood, with labor-like 
pains ; very impatient and cross. 

Chiiia. — Dangerous hemorrhage after miscarriage or labor ; 
discharge of clots of dark blood ; heaviness of the head, ring- 
ing in the ears, loss of sight, and fainting. 

I tested this remedy when I first became a homceopathist. 
I was called to see a case of post partum hemorrhage ; I found 
her sighing, purple around the eyes, dim sight, and nearly pulse- 
less. I put her on china every three minutes, and after taking 
three doses I observed a little rise in the pulse. I continued the 
remedy every five to thirty minutes, and in half to three quar- 
ters of an hour she rallied and made a rapid recovery. 

Crocus saliva.— After miscarriage or labor, or from over- 
exertion ; discharge of dark stringy blood, worse from the least 
exertion ; sensation as of something alive in the abdomen ; 
passive hemorrhage, in nervous, hysterical women. 

Hyoscyamus. — Labor-like pains in the uterus with hemor- 
rhage ; bright-red blood continuing to flow all the time. 

Ipecac. — Profuse hemorrhage of bright-red blood, coming 
away in a gush, with cutting pains around the navel, with 
bearing down ; great weakness and inclination to vomit ; after 
parturition or miscarriage. 

Sabina. — Profuse discharge of bright-red blood ; sometimes 
the discharge is dark, leaving blackish clots mixed with thin 



528 THEORY AND PRACTICE OF MEDICINE. 

waters' blood ; pains extending from the back through to the 
pubes. 

Secale cornutum. — Hemorrhage after parturition or mis- 
carriage ; want of action in the uterus ; discharge of dark 
liquid blood, with little or no pain. 

Sepia. — Induration of the neck of the uterus, with spas- 
modic painful pressure over the sexual organs ; chronic met- 
rorrhagia, when it is excited from the least cause. 

Sulphur. — Frequent attacks of hemorrhage ; she seems to 
get almost well, when it occurs again and again. 

If the case is very urgent we should grasp deep in the ab- 
domen and excite the uterus to contraction. A towel rung out 
in cold water and spread over the bowels, often gives tempo- 
rary relief, or the abdomen should be showered from a pitcher 
of cold water from a height. A wet handkerchief may be 
introduced into the vagina if the other means fail. If the 
flooding is due to a miscarriage, and the foetus and secun- 
dines are still in the womb then a tampon of cotton or other 
material should be introduced into the vagina and packed 
tightly and left intact until hemorrhage ceases, then it can 
be taken out and replaced if necessary. The remedy may be 
given right along. If the above remedies are given early in 
threatened abortion they will arrest its progress. 

PUERPERAL PERITONITIS. 

CHILD-BED FEVER. 

This condition often involves the womb and all of its at- 
tachments. It is different, however, from simple metritis in 
view of the fact that the former is contagious, while the latter 
is not. That is to savin child-bed fever there is an erysipela- 
tous virus generated which is contagious by contact. 

Symptoms. — This disease develops, as a rule, be- 
tween the third and fifth day after delivery. The patient 
complains of chilliness followed by rigors ; the countenance 
has a sad, anxious look; the pulse ranges from 120 to 150 



THEORY AND PRACTICE OF MEDICINE. 529 

beats per minute ; the temperature often going above 105 ° ; 
the lochia is suppressed, or intermits, and has a foul odor ; the 
abdomen becomes tender and tympanitic ; the knees are drawn 
up to shield the abdomen from the weight of the bed-clothes ; 
the head aches ; the eyes are glistening, and the patient is 
sometimes delirious. Five or six days are the average dura- 
tion of the disease, but it may last ten to eleven days. 

Prognosis. — In former years this was a most fatal dis- 
ease among parturient women. Homoeopathy, however, has 
greatly curtailed its mortality, as it has done in all other dis- 
eases, and it will still be less, when homoeopathic physicians 
will lay aside the hypodermic syringe, and stick close to the 
law of similia in the treatment of childbed fever. 

Treatment. — Aconite and mercurius cor. are the rem- 
edies, par excellence, in child-bed fever, and if given early will 
give the best show for recovery. As other symptoms may 
arise, I give a few remedies with their indications. 

Belladonna. — Headache, great tenderness in the abdomen, 
violent pains. 

Rhus tox. — Metritis after confinement ; she can not lie 
still, but must change continually to get a little rest ; the 
lower limbs seem powerless, she can hardly draw them up ; 
dry tongue with red lips ; typhoid condition, aggravation dur- 
ing rest, especially at night. 

Veratrum album. — Puerperal metritis with violent fits of 
vomiting and diarrhea ; coldness of the extremities with deadly- 
pale face, covered with cold perspiration, suppression of the 
lochial discharge. 

For other indicated remedies see under metritis. 

Puerperal Convulsions. — Convulsions coming on dur- 
ing labor. 

Symptoms. — At some stage of labor the patient has 
premonitory symptoms of the approach of convulsions. The 
pain in the head, giddiness, confusion, ringing noises in the 
ears, obscure vision, temporary loss of sensation, rigors, nausea, 

34 



530 THEORY AND PRACTICE OF MEDICINE. 

or vomiting. Sometimes, however, the patient has no warn- 
ing and is immediately thrown into convulsions. The face is 
swollen, dark-red or purple, tongue protruded, and is often 
lacerated by the closure of the jaws, with issuing of froth from 
the mouth. 

Causes. — Some suppose it to be due to a reflex action 
from the irritated uterus to the nervous centers. When death 
occurs it is preceded by symptoms of uremic poisoning of the 
brain. Hence this might be avoided by an examination of 
the urine once in awhile during the latter months of gestation, 
and keep the urine in a normal condition. 

Treatment. — If the convulsions appear suddenly the 
patient should be ansesthized as speedily as possible either by 
chloroform or ether, and when the patient rallies sufficiently 
one of the following remedies should be given as indicated. 

Aconite. — When the attack is apprehended ; flushed face, 
dry, hot skin, thirst and great restlessness ; vertigo on rising. 

Argentnm nitricum. — Tremor of the limbs, and faintish, 
weak feeling ; sensation as if the body, and especially the 
face and head expanded. She feels as if the bones of the 
skull separated, with increased temperature ; continually in 
motion between the spasms. 

Belladonna. — Red, bloated face, with distorted eyes and 
dilated pupils ; convulsive jerking of the limbs and muscles 
of the face. With every pain a spasm comes on, and during 
the interval more or less tossing about 

Cicnta. — Violent contortions of the upper part of the body 
and limbs ; convulsive tossing of the extremities from one 
side to another ; bluish face with interrupted breathing, and 
foam at the mouth. After the convulsion she lies motion- 
less, with rigidity of the jaws, and as if dead. 

Cuprum metallicum. — Spasms first of the limbs, then of 
the body ; eyes spasmodically closed, and the mouth distorted. 
Rigidity of the trunk and lower extremities, with closed jaws ; 
vomiting and retching, with colic and cramps in legs. 

Hyoscyamus. — Twitching and jerking of the muscles in 



THEORY AND PRACTICE OF MEDICINE. S3 1 

the body ; clenching of the thumbs in the palms of the hands ;, 
oppression of the chest, with stertorous breathing. 

Opium. — Spasms followed by sopor and stertorous respir- 
ation ; bluish, bloated face, with swollen lips. 



OVARITIS. 

INFLAMMATION OF THE OVARIES. 

I will include under this head neuralgia and enlargement 
of the ovaries. 

Symptoms. — Tenderness and pain are felt on one or 
both sides of the iliac region. The parts become swollen and 
hot ; she feels languid, with back-ache, headache, and a gen- 
eral nervous condition is developed. If the disease is not ar- 
rested at this stage, the ovary enlarges, and frequently an 
abscess forms. 

Treatment. — I wish to emphasize the fact, that if 
females would apply to homoeopathic physicians, in the very 
first stages of ovarian troubles, nineteen-twentieths of the 
cases could be cured, and thus save the annoyance of ovarian 
tumors and the danger of ovariotomy. 

Aconite. — If caused by cold, dry winds. 

Apis. — Stinging pains in the ovary, right side, which is 
swollen and tender to touch. Numbness in the right side of 
the abdomen, extending to the thigh ; ovarian tumor on the 
right side ; dropsy of the right ovary. 

Arsenicum. — Burning or tensive pain in the ovary, extend- 
ing to the thigh, which feels numb, with great restlessness.. 

Belladonna. — Stitching, throbbing pains in the right 
ovary, which is hard and swollen ; great heat and tenderness 
of the abdomen ; can not bear the least jar ; constant bearing 
down as if everything would issue from the vagina. 

Bryonia. — Stitches in the ovaries on taking a deep inspi- 
ration ; suppressed menses, with bleeding of the nose. 

Cantharis. — Burning pain, worse during menstruation j 



532 THEORY AND PRACTICE OF MEDICINE. 

ovaries extremely sensitive ; constant desire to urinate, pass- 
ing but a few drops, often mixed with blood. 

Coninm. — Induration and enlargement of the ovary, with 
lancinating pains, nausea and vomiting. 

Hepar siilphuris. — Enlargement of the ovaries, with great 
soreness, pain in back ; where suppuration has occurred or 
abscess imminent. 

Lachesis. — Ovaritis of left side ; swelling of the ovary, with 
drawing, pressing pains ; if pus has already formed ; can not 
lie on right side. 

Platinum. — Ovaries inflamed, with burning pains in parox- 
ysms ; chronic inflammation of ovaries, especially right ; ova- 
ritis has been relieved, even after suppuration has taken place. 

I have cured many cases of enlarged ovaries, the size of a 
large orange, by the use of the foregoing remedies, and the 
local application of a liniment composed of tincture of iodine, 
one ounce, tincture of aconite and belladonna, half an ounce 
each. I have the liniment applied morning and night. 

Vicarious Menstruation — This is a condition in which 
blood issues from the gums, nose, lungs, stomach, arms, blad- 
der, nipples, the end of the fingers and toes, when nature is 
unable to restore the menses through their normal channel. 

Treatment. — This must be adapted to hemorrhages in 
general, and the menses restored by the remedies given under 
suppressed menstruation. 

CESSATION OF MENSES. 

CRITICAL AGE. 

This is a period which most women dread. I can not see 
any reason for it ; for nine-tenths pass through the period with 
but little inconvenience. The period of ovulation with females 
is thirty years ; hence if they begin to menstruate at fifteen 
years of age, they will cease about forty-five. If they begin 
younger or older they will cease before forty-five or go over. 



THEORY AND PRACTICE OF MEDICINE. 533 

I knew a lady that bore a child at sixty years of age. It is 
because some latent disease is developed about the change of 
life that it is called the critical age. 

Treatment. — This must be adapted to the general 
condition of the patient. If there are excessive flowings at 
times, then the remedies suggested for hemorrhage will be in- 
dicated. 

Ferrnm. — Before menses, stinging headache, ringing in 
ears, discharge of long pieces of mucus from uterus ; pressure 
and burning on top of the head. 

Glonoinum. — Rush of blood to the head, with throbbing 
and noises in the head or ears ; giddiness. 

Lachesis. — Headache and sleeplessness ; also flushes. 

niSCARRIAQE. 

If an impregnated uterus gives up its contents before the 
sixth month, it is called an abortion ; subsequent to this 
period, premature labor. 

Treatment. — Aconite. — Threatened miscarriage in 
consequence of fright ; hemorrhage with fear of death. 

Apis. — Stinging, labor-like pain in the uterus ; sensations 
as if something in the abdomen would break. 

Arnica. — After a fall, blow, concussion, especially if labor- 
pains set in, with discharge of blood or serous mucus ; a sore, 
bruised feeling all over. 

Belladonna. — Face and eyes red, throbbing carotids, se- 
vere bearing down ; profuse discharge of bright red blood 

Cantharis. — Threatened abortion from congestion or ulcer- 
ation of the cervix uteri. Constant desire to urinate. 

Caulophyllum. — Threatened miscarriage, with profuse 
hemorrhage. Want of action in the uterus ; protracted 
lochia. 

Chamomilta. — Periodical labor-like pains, with discharge 
of dark-colored or coagulated blood. 

China. — Hemorrhage unto fainting, giddiness, and loss of 



534 THEORY AND PRACTICE OF MEDICINE. 

consciousness, ringing in the ears, and coldness of the ex- 
tremities after miscarriage. 

Hyoscyamus. — Discharge of light red blood, with labor- 
like pains ; twitching and jerking of single muscles or spasm 
of whole body. 

Ipecac. — Profuse discharge of bright red blood, with pres- 
sure downward ; nausea, and cutting pain around the navel. 

Pulsatilla. — The discharge is arrested for a little while, 
then returns with redoubled violence ; suffocative spells ; she 
craves fresh air, worse in a close, warm room ; retention of the 
after-birth ; mild, tearful women. 

Sabina. — Violent forcing or dragging pains extending 
from the back through to the pubes ; discharge profuse, con- 
sisting of bright-red, partly fluid and partly clotted blood. 

Secale cornutum. — After miscarriage has occurred ; copi- 
ous flow of black, liquid blood, worse from the slightest motion. 

MORNING SICKNESS. 

From one to five weeks after conception, nausea and vom- 
iting sets in, and lasts until after the third month. The pa- 
tient feels worse in the morning when first rising, hence it is 
called morning sickness. It is due to reflex action from the 
nterus to the stomach. 

Treatment. — The case is sometimes a most annoying 
thing to handle, but when we get symptoms corresponding to 
our remedies it is readily managed. 

Antimonium crudiim. — Persisting vomiting, with convul- 
sions. 

Arsenicum. — Vomiting, especially after eating or drink- 
ing ; wants little water but often. 

Bryonia. — Nausea immediately on waking in the morn- 
ing ; lips dry and parched ; dry mouth and tongue, with much 
thirst ; headache, she feels better by keeping perfectly quiet. 

Cocculus. — In the morning she' can scarcely rise up on ac- 
count of nausea and inclination to vomit. 



THEORY AND PRACTICE OF MEDICINE. 535 

Cont'um. — Nausea and vomiting ; sour eructations, with 
burning in the stomach ; swelling and soreness of the breasts. 

Ipecac. — Continual nausea all the time, not a moment's re- 
lief ; vomiting of large quantities of mucus. 

Nux vomica. — Acrid and bitter eructations and regurgita- 
tions. She feels as if she would be better if she could vomit. 

Phosphorus. — Nausea with hunger early in the morning ; 
sour vomiting and sour eructations. 

Septa. — Nausea in the morning as if all the viscera were 
turned inside out. The very thought of food sickens her ; 
yellowness across the nose. 

Tabacum. — Nausea and vomiting as soon as she begins 
to move ; during pregnancy deathly nausea. 

Tartar emetic. — Continuous nausea; vomiting of large 
quantities of mucus. 

Veratrum album. — Constant nausea and ptyalism. Ex- 
cessive vomiting of bile, mucus, and, lastly, blood. Cold 
sweat on the forehead ; craves cold drinks. 

A cup of strong coffee before rising in the morning will 
give quiet during the day. I have relieved patients by let- 
ting them drink sour milk. The colon douche sometimes 
gives relief. I have seen good results from the application of 
a bag of ice along the spine for a few minutes. I let my pa- 
tients eat and drink whatever they crave. 

SPERMATORRHOEA. 

INVOLUNTARY EMISSIONS. 

Like most other writers, I was about to pass this subject 
by, and yet the health, mentally and physically, of more young 
men are undermined by this habit than almost anything else. 
I have heard physicians say to young men that it was a physi- 
ological necessity, and hence nothing could be done for it. 
This is a mistake, for I have relieved many with homoeopathic 
treatment. After the habit continues for several months, the 
patient becomes despondent, and finally the intellect becomes 



536 THEORY AND PRACTICE OF MEDICINE. 

impaired. The same results follow by masturbation or self- 
abuse, both in boys and girls. Nurses should be taught to 
handle the genital organs of children as little as possible. 
Spanking children on the hips often develops the sexual de- 
sire. Children should be taught that it is very immodest for 
them to handle those organs more than is absolutely neces- 
sary. There is a little too much mock modesty on the part 
of physicians in giving parents instructions on this all impor- 
tant subject, for if neglected, a bright intellect may be dwarfed. 
Treatment. — A cold sponge bath is the first thing to 
be mentioned to a patient before retiring at night. 

Agnus castus. — Emissions at night ; semen discharged in 
a stream, without ejaculation. 

Argentum nitricum. — Emissions at night ; with lascivious 
dreams ; frequent and copious. 

China. — Nocturnal emissions, frequent and debilitating. 
Digitalis purpurea. — Nightly emissions, with great weak- 
ness of the genitals. 

Ferrum. — Seminal emissions, anaemic persons. 
Gelsemium. — Involuntary emissions without erections; 
spermatorrhoea ; emission of semen during stool. 

Iris versicolor. — Nocturnal emissions, with amorous dreams ; 
coldness and itching of the parts. 

Staphysagria. — Effects of onanism ; face sunken ; abashed 
look ; nocturnal emissions ; backache ; weak legs ; organs re- 
laxed. 

Sulphur. — Involuntary discharge of semen, with burning 
in the urethra. 

f here are other valuable remedies mentioned, but I have 
( found the above to be sufficient. I neglected to mention mer- 
curius biniodide as a valuable remedy in some cases. 



THEORY AND PRACTICE OK MEDICINE. 537 



APPENDIX, 



TOOTHACHE. 

As a rule, when a tooth is decayed and can not be saved 
by filling, it should be extracted. But as there are times 
when it is best not to extract, then the following remedies 
are very valual^le. 

Treatment. — Aconite. — Stitching or throbbing pains, 
with congestion of blood to the head, and great restlessness. 

Antimonium crudum. — Pains worse after eating, or from 
cold water. The gums bleed readily, and recede from the 
teeth. 

Arnica. — Pain after a bruise ; cheek swollen, red and 
hard; sore feeling all through body. 

Arsenicum. — Blongation and painful looseness of the 
teeth ; pains extending to ears, cheeks, and temples ; restless ; 
drinks often, and but little. 

Bryonia. — Pains in carious, and still more in sound teeth ; 
worse at night, or from taking any thing warm in the mouth. 

Calcarea carb. — The pains worse from air, by any thing 
warm or cold, or by the slightest change ; scrofulous diath- 
esis. 

Carbo veg. — Receding and bleeding gums, with ulcers ; 
teeth loose and sensitive after any thing salty. 

Chamomilla. — Pains drive one almost to despair; worse 
during the night ; gums red and swollen. 

China. — Periodical pains, relieved by pressing the teeth 
firmly together ; worse from cold air. Nursing females, and 
persons debilitated from loss of animal fluids. 



538 THEORY AND PRACTICE OF MEDICINE. 

Coffea. — The pain is relieved by ice-cold water. Head 
feels contracted or too small ; can not sleep ; loss of taste. 

Cyclamen. — Tearing in the three left molar teeth, as if 
they were being torn out ; lasting all night. 

Dulcamara. — From cold, damp weather. 

Euphorbium. — Teeth sore to the touch, and are liable to 
crumble and break off. 

Fhwric acid. — Fistula about the teeth and gums. The 
teeth are extremely sensitive. 

Glonoinum. — Pulsating toothache, with headache. 

Hyoscyamus. — Swelling of the gums, with a tearing pain 
and buzzing in the tooth, which appears loose. Spasmodic 
twitching of the fingers, hands, arms and facial muscles. 

Kreosotum. — Toothache, pain extending to the gums. It 
not only gives relief, in carious toothache, but arrests caries. 

Mercurius. — Pains extend to the ear, or jumping tooth- 
ache, especially at night. Teeth feel sore, loose and too long. 

Mezereum, — Pain in the periosteum of the sockets of the 
teeth, extending to the malar bones and temples. 

Nux moschata. — Suitable to children, and women during 
pregnancy. Better from warm water applications ; great dry- 
ness of the mouth, and disposition to faint. 

Nux vomica. — Toothache after dinner ; boring, gnawing 
toothache, better on inspiring air ; worse from mental ex- 
ertion. 

Phosphorus. — Tearing, shooting pains ; worse in open air, 
or from warm food. Decayed teeth, with gum-boils. 

Pulsatilla. — Drawing toothache, as if the nerves were put 
upon the stretch, and let loose again suddenly ; worse from 
warmth, better from cold. 

Rhus tox. — Painful soreness of the face; aggravated dur- 
ing rest and in damp weather ; better from the application of 
external heat ; prevents caries of the teeth. 

Sepia. — Toothache during pregnancy ; the pains extend to 
the ears, and along the arm to the fingers, where they termi- 
nate in a creeping sensation. 



THEORY AND PRACTICE OF MEDICINE. 539 

Silicea. — Suppurations about the sockets of the teeth ; 
toothache from warm food. 

Spigelia. — Pain most violent in the decayed teeth ; pain- 
ful jerks, aggravated by cold water. 

Staphysagria. — Black, carious teeth which crumble ; pale, 
white, ulcerated, swollen, and painful gums. 

Sulphur. — Toothache in the open air, or from draught ; 
the teeth feel elongated ; the teeth feel loose when eating ; 
burning heat in top of the head, and cold extremities. 

The people should be instructed to keep their teeth clean 
and free from tartar, and as soon as a tooth begins to decay 
have it filled with gold or anything but amalgam, for as that 
contains mercury it is liable to affect the system. 



TABLE OF CONTENTS. 



Abnormal Voice Sounds 62 

Acne 456 

Ague 130 

Allopathy 8 

Amaurosis 494 

Amenorrhcea 515 

Anasarca 350 

Anaemia 296 

Aneurism 290 

Angina Pectoris 281 

Angina Trachealis 250 

Angular Curvature of the Spine 425 

Aphonia, or Loss of Voice 249 

Aplastic Diathesis 27 

Apoplexy 402 

Appendecitis 327 

Ascites 352 

Asthma 260 

Atrophy of the Heart 288 

Auscultation 57 

Bed-sores 223 

Biliary System 343 

Bilious Fever 149 

Blood, Normal Elements 22 

Blood, Excrementitious Elements 22 

Boil 472 

Brain-fag 386 

Branny Tetter 465 

Bronchial Rale 60 

Bronchitis 252 



II TABLE OK CONTENTS. 

Bruise 482 

Brow Ague 157 

Bullae 452 

Burns and Scalds ... 480 

Bursitis 477 

Cancer of Stomach 315 

Canker of the Mouth 299 

Capillary Bronchitis 259 

Carbuncle 474 

Cardiac Asthma = 262 

Carditis 287 

Caries 226 

Catalepsy 394 

Cataract 498 

Catarrh 242 

Catarrhus Epidemicus 244 

Catarrhal Ophthalmia 484 

Causes of Disease 45 

Causes of Fever 74 

Cerebral Sclerosis 425 

Cerebro-Spinal Meningitis 421 

Chafing of Infants 444. 

Child-bed Fever 528 

Chilblains 241 

Chicken-pox 445 

Cholera Infantum 321 

Cholera Maligna — Asiatic Cholera 318 

Cholera Morbus 317 

Choroiditis 493 

Circulatory System 278 

Clergyman's Sore Throat 303 

Coccyxitis 425 

Colic 336 

Concussion of the Brain 418 

Concussion of the Spine 425 

Cornitis 490 

Consumption , 212 

Contagiousness 75 



TABLE OF CONTENTS. Ill 

Contusion 482 

Constipation 334 

Convulsions 414. 

Coryza 243 

Crick-in-the-Neck 236 

Croup Membranous 250 

Croup Spasmodic 250 

Cutaneous System 442 

Cyanosis 290 

Cystitis 372 

Deafness 510 

Death 65 

Death, Modes of 66 

Delirium Tremens 435 

Dementia 432 

Dengue Fever 199 

Dentition 300 

Diarrhea 328 

Diabetes 367 

Diatheses 26 

Diagnosis 50 

Digestive System 297 

Dilatation of the Heart 289 

Diseases 70 

Diseases, Classification of 72 

Diseases of the Intestines 325 

Diseases of the Stomach 309 

Diseases of the Stomach and Intestines 317 

Diseases of the Bladder 372 

Diseases of the Eye 484 

Disorders of the Mind 427 

Dry Joints 240 

Duodenitis -327 

Dysentery . 331 

Dysmenorrhea 518 

Dyspepsia — Indigestion 311 

Dysuria, Difficult Urination 374 



IV TABLE OF CONTENTS. 

Ear Diseases 505 

Ear Boils or Abscesses 506 

Ear, Discharge from 194 

Ear, Noises in 513 

Eclectics 7 

Ecthyma 454 

Eczema 445 

Elephantiasis 466 

Encephalitis 417 

Endocarditis 283 

Enteritis 325 

Enuresis 375 

Epilepsy 405 

Equinia 460 

Erythema 442 

Esophagus, Inflammation 306 

Esophagus, Spasm of 307 

Eye, Diseases of 484 

Eye-lids 501 

Eye-lids, Granular 502 

Eye-lids, Agglutinated 503 

Eye-lids, Vesicular 503 

Facial Paralysis 399 

Fainting 280 

Feet, Frosted 241 

Felon 476 

Fever, Continued 8^ 

Fever, Typhoid 86 

Fish-skin 465 

Fistula Lachrymalis 504 

Frambcesia 468 

Freckles , 471 

Furunculus 472 

Gall-Stones 348 

Ganglion 483 

Gangrenosum 208 

Gangrene of the Lungs 270 

Gastralgia 312 



TABLE OF CONTENTS. V 

Generative Diseases 515 

Gastritis 309 

Glaucoma 499 

Glossitis 301 

Glosso Laryngial — Paralysis 400 

Goitre ,< 263 

Gout — Podagra 238 

Gravel — Stone 363 

Grippe 244 

Gutta Serena 494 

Hardness of Hearing , 510 

Hay Asthma 262 

Headache 390 

Heart, Neuralgia of 280 

Hematemesis 313 

Haematuria 365 

Hemorrhage from the Bowels 333 

Hemorrhoids 340 

Hepatitis 346 

Herpes 449 

History of Medicine 5 

Homoeopathy 10 

Whooping-Cough 276 

Hordeolum 501 

Housemaid's Knee 477 

Hydrocele 357 

Hydrocephalus 353 

Hydropathy 8 

Hydrophobia 411 

Hydrothorax 354 

Hyperplastic Diathesis 36 

Hypertrophy of the Heart 287 

Hypochondriasis 380 

Hysteria 412 

Hysteralgia 521 

Ichthyosis 465 

Indigestion 311 

Impetigo 455 

35 



VI TABLE OF CONTENTS. 

Incontinence of Urine 375 

Inflammation of the Spinal Cord 418 

Inflammation of the Eye-lids 501 

Infantile Convulsions 414 

Inflammation of the Ovaries 531 

Inflammation 78 

Inflammation of the Brain 417 

Influenza or Grippe 244 

Insane Impulse 434 

Inspection 53 

Insomnia 384 

Intertrigo 444 

Intermittent Fever 1 30 

Intermittent Fever, Treatment 140 

Intermittent Pulse 279 

Iritis 492 

Itch 451 

Itching of the Anus 342 

Jaundice 343 

Land Scurvy 294 

Laryngitis 246 

Lateral Curvature of the Spine 426 

Lepra Vulgaris 464 

Leprosy 466 

Leucorrhcea 525 

Lichen » 462 

Liver-Spots 472 

Local Diseases 242 

Lock-jaw 410 

Locomotor Ataxia 401 

Low Spirits 380 

Lumbago 236 

Lupus 469 

Malignant Pustules 473 

Mania 428 

Measurement 53 

Measles 177 



TABLE OF CONTENTS. VII 

Measles, Treatment of 179 

Melancholy 389 

Meningitis 419 

Menorrhagia , 519 

Menses, Cessation of 532 

Mentagra 457 

Metritis 522 

Metrorrhagia 526 

Milk Fever 113 

Miscarriage 533 

Moles 471 

Molluscum 469 

Monomania 433 

Moral Insanity 433 

Morbus Coxae 227 

Morning Sickness 534 

Mother's Mark 471 

Mumps 307 

Musculae , 470* 

Muscae Volitantes 497 

Myelitis 418 

Myopia — Near-Sighted 50a 

Naevus 47 r 

Nasal Catarrh 195 

Natural Respiratory Murmur 58 

Nephritis 358 

Nettle-Rash 443 

Neuralgia 382 

Neuralgia of the Heart 280 

Neurological Diseases 380 

Night Emissions 536 

Normal Resonance 62, 

Offensive Breath 298" 

Ophthalmia Neonatorum 486 

Organic Diseases of the Heart 28 1 

Otitis Externa 505; 

Otitis Interna 507 

Otorrhcea 509, 



VIII TABLE OF CONTENTS. 

Ovaritis 531" 

Painter's Colic 338 

Palsy 396 

Palpation 54 

Palpitation 278 

Pancreatitis 349 

Pemphigus „ 452 

Paralysis 396 

Paraplegia 398 

Percussion 55 

Perforation of the Stomach 314 

Pericarditis 282 

Periodical Fever 130 

Periodical Neuralgia 157 

Phlebitis 291 

Phlegmasia Dolens 291 

Phthisis 212 

Piles 340 

Pimples 461 

Pityriasis 465 

Plastic Diathesis 34 

Plague — Pestilentia 210 

Pleurodynia 236 

Pleuritis 273 

Pneumonia 264 

Porrigo 458 

Poison of Insects 478 

Practice of Medicine 78 

Presbyopia 501 

Pressure 54 

Primary Sounds 57 

Prognosis 64 

Prolapsus Ani 342 

Prostatitis 378 

Pulse * 50 

Puerperal Peritonitis 528 

Prurigo .462 

Pruritus 462 

Pruritis Ani 342 



TABLE OF CONTENTS. IX 

Purulent Ophthalmia 485 

Psoriasis 464 

Ptosis 400 

Puerperal Convulsions 529 

Pustules 454 

Quinsy, Tonsillitis 304 

Rachitis 229 

Relapsing Fever 120 

Relaxed Throat . . . 303 

Remittent or Bilious Fever 149 

Remittent or Bilious Fever, Treatment of 153 

Retention of Urine . . 376 

Retinitis 494 

Rheumatism 230 

Roseola 444 

Rubeola 177 

Rupia 453 

Scalds 480 

Scarlatina or Scarlet Fever 183 

Scaly Diseases 464 

Sciatica 237 

Scrivener's Palsy 400 

Scrofulosis or Scrofula 211 

Scurvy 294 

Sclerotitis 489 

Sea-Sickness . 395 

Sea Scurvy 295 

Secretory System 350 

Sequelae of Malarial Fevers 155 

Serpent's Bite 479 

Shaking-Palsy 400 

Shingles 449 

Sick-Headache 383 

Simple Continued Fever 83 

Small-Pox 165 

Sore Throat 302 

Spasmodic Croup 250 



X TABLE OF CONTENTS. 

Spermatorrhoea • • 535 

Spine, Angular Curvature of the . ..425 

Spinal Irritation . . . . 424 

Spine, Lateral Curvature of the 426 

Spinal Meningitis 424 

Spinal Sclerosis 425 

Spotted Fever „ 421 

Sprain — Strain 483 

Stiff-Neck or Crick-in-the-Neck 236 

St. Vitus's Dance 407 

Stomatitis 297 

Strabismus 500 

Strophulus. . . o 461 

Strumous Ophthalmia 488 

Sty 501 

Suppression of Urine 366 

Sun-Stroke 439 

Syncope 280 

Tabes Mesenterica 226 

Teething 300 

Theory and Practice of Medicine 16 

Tetanus 410 

Thermometer 51 

Thrush 298 

Tissues, Elementary Properties of 23 

Tissues, Elementary 25 

Traumatic Erysipelas 208 

Tongue 52 

Tonsillitis 304 

Toothache 537 

Tympanitis 339 

Typhoid or Enteric Fever 86 

Typhoid Fever, Treatment of 103 

Typhus Fever 116 

Tuberculosis or Scrofulosis 211 

Ulcer on the Tongue 302 

Ulcerated Throat 303 

Ulceration of the Stomach 314 



TABLE OF CONTENTS. XI 

Urinary System 358 

Urine, Bloody . 365 

Urticaria 443 

Uterus or Womb, Inflammation of 522 

Vaginitis 524 

Valvular Diseases of the Heart 284 

Variola 165 

Variola, Treatment of 174 

Varioloid 170 

Varicose Veins 292 

Varicose Ulcers 293 

Vertigo 392 

Vesicular Rale 60 

Voice Sounds 61 

Voice, Loss of 249 

Vomiting of Blood 313 

Warts 478 

Water-Brash 312 

Wen 478 

Whitlow 476 

Womb or Uterus 522 

Yellow Fever 158 

Yellow Fever, Treatment of 162 



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